Earnings Labs

Gilead Sciences, Inc. (GILD)

Q1 2019 Earnings Call· Thu, May 2, 2019

$128.98

+0.94%

Key Takeaways · AI generated
AI summary not yet generated for this transcript. Generation in progress for older transcripts; check back soon, or browse the full transcript below.

Same-Day

+2.80%

1 Week

+1.27%

1 Month

-1.50%

vs S&P

+2.16%

Transcript

Operator

Operator

Ladies and gentlemen, thank you for standing by, and welcome to the Gilead Sciences' First Quarter 2019 Earnings Conference Call. My name is Jonathan and I will be your conference operator today. At this time, all participants are in a listen-only mode. And as a reminder, this conference call is being recorded. I would now like to turn the call over to Sung Lee, Vice President of Investor Relations. Please go ahead.

Sung Lee

Management

Thank you, Jonathan, and good afternoon, everyone. Just after market closed today, we issued a press release with earnings results for the first quarter 2019. The press release and detailed slides are available on the Investor Relations section of the Gilead website. The speakers on today's call today will be; Daniel O'Day, Chairman and Chief Executive Officer; Robin Washington, Executive Vice President and Chief Financial Officer; Laura Hamill, Executive Vice President, Worldwide Commercial Operations; and John McHutchison, Chief Scientific Officer and Head of Research and Development. Before we begin with our prepared comments, let me remind you that we will be making forward-looking statements, including plans and expectations with respect to products, product candidates, financial projections and the use of capital, all of which involve certain assumptions, risks and uncertainties that are beyond our control and could cause actual results to differ materially from these statements. A description of these risks can be found in our latest SEC disclosure documents and recent press releases. In addition, Gilead does not undertake any obligation to update any forward-looking statements made during this call. Non-GAAP financial measures will be used to help you understand the company's underlying business performance. The GAAP to non-GAAP reconciliations are provided in the earnings press release as well as on the Gilead website. I will now turn the call over to Dan.

Daniel O'Day

Management

Thank you, Sung, and good afternoon, everyone. I'm really pleased to join all of you today for my first earnings call at Gilead. Rob and Laura and John will take you through the key highlights of the quarter, but I'd like to share and start by sharing some of the perspectives that I gained since arriving here in March. As many of you know when I made the decision to join Gilead, I was drawn to the potential that I saw to build on the legacy of transforming care for people with serious illnesses in a company that has a deep commitment to patients and science. I now had a chance to see the extent of that potential up close. Let me share some of what I've observed, the areas that I focused on up until now and a few thoughts on what you can expect next. The first thing, I'll say is that it's been really exciting to see the scientific strength from the perspective of being inside the company. I've taken part in a series of deep dives into the R&D programs in each of our therapeutic areas. This includes spending time at KITE to dig into our work in cell therapy. I'm excited about the progress that we're making in inflammation and with the results of FINCH 1 and FINCH 3 are the studies that were announced at the end of March. John will walk you through the detailed study results later in this call, but I just want to express my enthusiasm for this work, as we mobilized the organization for the launch of filgotinib, a medicine that will be a significant step forward for patients with rheumatoid arthritis. Inflammation is one of the three emerging areas for us and we anticipate that filgotinib will be…

Robin Washington

Management

Thank you, Dan, and good afternoon everyone. We are pleased to share our financial results for the first quarter of 2019. Total revenues for the first quarter were $5.3 billion with non-GAAP diluted earnings per share of $1.76. This compares to revenues of $5.1 billion and non-GAAP earnings per share of $1.48 for the same period last year. Turning to product sales. Product sales for the first quarter were $5.2 billion, up 4% year-over-year and down 8% sequentially. This is the first quarter in the past three years where the company has posted year-over-year growth and it reinforces our belief that the company can grow product sales year-over-year on a full year basis. In the U.S., product sales for the first quarter were $3.8 billion, up 8% year-over-year and down 15% sequentially. The sequential decline was primarily due to the anticipated inventory drawdown associated with our HIV products reflective of the seasonal inventory pattern from the fourth quarter to the first quarter. As expected, our HIV payer mix moved more toward public payers, which also contributed to the sequential decline. Combined inventory and payer mix contributed an estimated $400 million to the sequential decline. Turning to Europe. Product sales for the first quarter were $882 million, down 12% year-over-year and up 8% sequentially. Sequentially, the increase was due to an unfavorable accounting adjustment related to statutory revenue callback reserves recorded in Q4. Without these Q4 adjustments product sales would have been flat. On a year-over-year basis, the decline was driven by lower HCV sales due to lower patient starts and competitive dynamics and the broader availability of generic HIV products in 2019. Now turning to expenses. Non-GAAP R&D expenses were $871 million for the first quarter, up 7% compared to the same period last year, primarily due to higher investments…

Laura Hamill

Management

Thank you, Robin. Good afternoon everyone. I will provide an update on our commercial performance during the first quarter and share highlights from markets around the world. Beginning with HIV. We continue to see double-digit revenue growth on a year-over-year basis led by uptake of our Descovy-based regimen and growing use of Truvada for PrEP. In the U.S. HIV revenue was $2.8 billion in the first quarter, up 19% year-over-year and down 17% quarter-over-quarter. As Robin noted, the sequential change reflects the anticipated inventory drawdown and payer mix in the first quarter. This trend is a typical pattern that we see between Q1 and the preceding Q4. Underlying prescription demand remains robust growing 12% year-over-year. We continue to see excellent adoption of Biktarvy. It is become the top-selling product in the U.S. and generated $739 million in revenue. It remains the number one prescribed regimen in both treatment-naïve and switch patients. Approximately 80% of Biktarvy's U.S. prescriptions come from switches, with about 25% coming from Genvoya and 25% coming from dolutegravir-based regimens. Overall, Descovy-based regimens continue to gain share and now account for approximately 80% of Gilead's total U.S. treatment prescription volume. In Europe, total HIV revenue was $569 million in the first quarter, down 7% year-over-year and up 11% quarter-over-quarter. The year-over-year decline was driven by the broad availability of generic versions of Truvada across the EU. The decline however is moderating, as we continue to see rapid uptake of our Descovy-based products, which now account for almost 80% of our total HIV revenue in Europe in the first quarter. Biktarvy is now available in Germany, France and Spain. We anticipate launching in the U.K. and Italy mid-year. We are encouraged by the strong uptake of Biktarvy across all markets where we have launched. In 2018, we launched Biktarvy…

John McHutchison

Management

Thank you Laura, and thank you everyone for joining us today. Let me start by saying that this has been another important quarter for the R&D part of our organization, and I remain excited about our ongoing program. So far this year, we have had five Phase 3 registrational clinical trials readout. I will spend some time discussing these studies and then cover other progress we are making across our pipeline. In March, we announced additional positive results from our FINCH program in rheumatoid arthritis. FINCH 1 and FINCH 3 Phase 3 studies of our selective JAK1 inhibitor filgotinib in adults with moderately to severely active rheumatoid arthritis each met their respective primary endpoint. Taken together with the FINCH 2 data reported last year, the three FINCH datasets support the potential of filgotinib as an important treatment option across the broad range of patient populations with rheumatoid arthritis. FINCH 3 evaluated filgotinib in combination with methotrexate and as monotherapy in methotrexate-naïve patients. Filgotinib is generally well tolerated and met the study's primary endpoint in terms of the proportion of patients achieving an ACR20 response at week 24 of treatment. In addition, the proportion of patients achieving the primary endpoint was significantly higher for filgotinib 200 milligrams plus methotrexate and filgotinib 100 milligrams plus methotrexate compared with methotrexate alone. Key secondary endpoint, specifically ACR50 and ACR70 or deeper responses and clinical remission rates at week 24 were also significantly higher with filgotinib plus methotrexate compared with patients receiving methotrexate alone. Now the FINCH 1 trial evaluated filgotinib compared to adalimumab or placebo on a stable background dose of methotrexate in patients with the prior inadequate response to methotrexate. The safety profile of filgotinib was also consistent with previously reported results. And the study also achieved its primary endpoint for both doses…

Operator

Operator

Thank you. [Operator Instructions] Our first question comes from the line of Geoffrey Meacham from Barclays. Your question please.

Geoffrey Meacham

Analyst

Hey guys, thanks for the question and Dan welcome to your first Gilead call.

Daniel O'Day

Management

Thanks Geoff.

Geoffrey Meacham

Analyst

So, I know you just finished the listing 2, but at this point how much of a strategic priority would you say the NASH portfolio or the hep B portfolio is? And if the answer is high, how aggressive you think you want to be on the BD front to add assets to these two categories? Thanks very much.

Daniel O'Day

Management

Yes great. Thanks Geoff. It gives me a chance to maybe just characterize what I've seen so far. So, I've obviously seen as all of you have the incredible depth of strength in HIV and in HCV and more broadly from HCV into liver diseases where obviously NASH and hep B are paramount. At the same time, I've had a chance to see the broader portfolio in inflammation with filgotinib at the lead of a comprehensive life cycle management program as well as some very interesting partnerships and earlier-stage molecules in inflammation. And likewise in oncology, of course, with the cell therapy being in a leadership position and all the life cycle managements that go around cell therapy, but also the interesting partnerships around both the biologics and small molecule oncology program. So -- still early days of digging into that, but I've been impressed by the breadth, I would say of the portfolio and the partnerships and some of the recent BD activities. Now specifically related to NASH and hep B, I would say that, what I've come to understand about NASH is the significant unmet medical need and growing unmet medical need I would say. And although, the results in the first quarter this year didn't turn out as we had expected, it's very clear that this disease -- needs scientific advancements. It's a heterogeneous disease. There are challenges with diagnosis. And at the same time, Gilead's experts in liver disease make it an area of continued interest for us and I'm particularly interested in the fact that a disease like this with the challenges associated with it may very well require combination therapies. And of course, we'll have some readouts and our combination approaches in the second half of this year, and you heard already from John some of the partnerships that we're entering to in that front. Hep B, similarly I mean, obviously, we have a treatment for hep B today, which we will continue to focus on. But the opportunity to continue to try to advance the science in hep B particularly around moving towards a cure is something that I've been impressed by to see the different scientific approaches that the scientists here at Gilead are looking at. So bottom-line Geoff is that I think that NASH and hep B as areas of liver and with the expertise of Gilead are areas we need to continue to explore both internally and through partnerships as a part of a broader portfolio of approaches across different therapeutic areas.

Operator

Operator

Thank you. Our next question comes from the line of Brian Abrahams from RBC Capital Markets. Your question, please.

Brian Abrahams

Analyst

Hi. Thanks very much for taking my question. On filgotinib. Coming out of FINCH 1 and 3 where do you see the most differentiation for that product versus currently available in late-stage -- therapies in late-stage JAK1 inhibitors? And obviously you're waiting FDA feedback, but I'm curious your willingness to file prior to completion of the MANTA study. I guess, how do you weigh speed to market for that product in a competitive space versus having to potentially optimize label right of the pad at the launch? Thanks.

John McHutchison

Management

Thanks, Brian. It's John here. Multi-part question. But look we are -- let me just step back a bit and think time -- summarize what we think about the entire data set. We have the full data package now from a Phase III clinical trial. We have over 3.5 – 3,200 patients. Look we've shown in terms of characterization and although it's hard to do head-to-head comparisons across drugs, across studies of course. What we have seen in our FINCH program consistent with our Phase II program is deep efficacy responses in broad patient population. And if you're a practicing rheumatologist that's what's most important to you. You're not getting to ACR20 you're getting strong ACR50 and strong ACR70 responses -- remission responses low disease activity. And all the FINCH trial shows those deep responses when you characterize them by those characteristics. Look each of the studies achieved all of their primary endpoints, and they showed improvement in functional status. And where we explored it we showed that we could slow the rate of structural damage on the X-ray files. So these are all important additional advantages of the drug or what we showed in that clinical programs So we'll go to -- as I said today on the earnings call we have the full data package. We're impressed by the risk benefit. We think it's relevant to patients and rheumatologists. We'll be able to file in Europe in the second half of this year, and we'll go and have a discussion now with the FDA. We've requested that meeting where we'll sit down and talk with them about what we have in terms of data from the MANTA studies what we have in terms of our Phase III registrational programs and what we should do. And the time the…

John McHutchison

Management

And of course, if I could add -- thank you, Dan but the safety -- I forgot to mention --unfortunately, the safety profile. We actually had a press release about this because we thought it was important as well. And again, it's impossible to make cross-drug cross-trial comparisons, but the safety profile we're seeing with this JAK1-specific inhibitor leads us to believe we have an additional benefit for patients as well. We're seeing low rates of infections, low rates of discontinuation, herpes zoster, thromboembolic events, cardiovascular events and so forth. So we also believe that that's an important advantage for the patients as well.

Operator

Operator

Thank you. Our next question comes from the line of Geoffrey Porges from SVB Leerink. Your question please. Mr. Porges, you might have your phone on mute?

Geoffrey Porges

Analyst

Thank you very much. Sorry, about that. Robin, it might be premature to say congratulations. I know you're around through the end of the year, but at the very least just wondering if you could help him with some Gmail settings. My storage is getting a little filled up.

Robin Washington

Management

I will work on that in 2020, Geoff.

Geoffrey Porges

Analyst

I'm sure you could take care of that. But seriously Dan, I wonder if you could comment and perhaps Robin could weigh in on this as well about capital allocation. You effectively returned 100% of your cash flow to shareholders through dividends and share buybacks this quarter. And obviously that's not really sustainable. But Dan, could you talk about how you feel about dividends versus buybacks? And whether you will be willing to make any firm commitment to a certain proportion of cash flow being returned to investors versus other items? Thanks. A – Daniel O'Day: Sure Geoff. And I know that Robin want to weigh on this as well but let me just say a couple of things. As you noted in my priorities, my top three priorities obviously focusing on the pipeline and understanding it both from a internal Gilead perspective and also what's on the outside horizon is my top priority as you can imagine. And therefore, I'm really pleased to get my deep dives into the R&D organization, but equally I should mention this. I spent a good amount of time with our corporate development organization and I think it's working really hand in glove with our research colleagues to identify and scan the external environments. And you can see the level of activity we've had now over the past year or so 1.5 years lots of partnerships and things that are going to supplement that portfolio, so back to the capital allocation. I consider it really to be in the following order in terms of priority. And the first one is where we can find opportunities to supplement our portfolio through M&A or partnerships that's priority number one because we think that's in the best interest of the long-term journey of shareholders in the company.…

Operator

Operator

Thank you. Our next question comes from the line of Michael Yee from Jeffries. Your question please. Q – Michael Yee: Hey, thank you. I wanted to ask question to Dan. You listed pipeline enhancement as a top priority. Maybe just speak a little bit more to that in terms of how you're thinking about prioritizing parts of the pipeline. I mean at Roche which obviously you had a long time at. You didn't really do any deals about $8 billion but maybe just talk about how you think about what may be different here at Gilead and maybe the appetite for M&A? How you're looking at the environment out there here at Gilead? Thanks so much. A – Daniel O'Day: Yes, thanks Michael for the question. I mean maybe just to expand a little bit from the previous question, I would say that as usual I think priority number one is to -- is that our M&A activity is led by science at the end of the day. And therefore, one focuses on so many expertise that we have within the company and that would obviously be in the areas of now oncology with the acquisition of KITE and the growing portfolio, we have here liver diseases inflammation and HIV. Not to suggest that we want to be opportunistic on something that has an interesting scientific profile and a high unmet medical need where we think we could bring out a transformational difference. So I want you to know we're scanning the entirety of the environment and we're science-led. But obviously I think overall, you're generally better positioned to identify the opportunities where you have expertise in-house. And I think that was true in my previous company and its also seems to be true from what I've seen here…

John McHutchison

Management

I completely agree, Dan. I think we've always had the philosophy and the success with being led by the science. We feel much comfortable in making those decisions when we have the expertise internally as you articulated. And we are opportunistic and prepared to take risks when we feel the science and the opportunity and the need exists.

Operator

Operator

Thank you. Our next question comes from the line of Carter Gould from UBS. Your question please.

Carter Gould

Analyst

Great. Good afternoon. Thanks for taking the question. Maybe to follow-up Dan on your comments around the KITE organizational structure and separating that as a own business unit. Maybe talk about what drove the decision? What you hope that will achieve? And maybe any sort of consequences for future BD focused on cell therapy? Thank you.

Daniel O'Day

Management

Absolutely, Carter. Yes I think the bottom line is that, I've been very encouraged by what I've seen at KITE, since I've come in and how the Gilead colleagues have approached to their entry into oncology in a very significant way. I think the concept of moving towards a new platform a new technology in this space as an entry point into oncology having come from a background of deep oncology experience and understanding the depth of a competitive environment is an intriguing way to go. So, to really go for a future-oriented technology I think makes a lot of sense. And then to supplement that, with interesting partnerships like the one that John and his team have done in bispecific antibodies for instance with Agenus and/or some of the interesting small molecule work that's going on here within the walls of Gilead. So first and foremost, I think one needs to consider the early, but interesting oncology work that's going on here at Gilead. And then, with that context we said – I said, as I've looked out in discussions with the leadership team that KITE itself in cell therapy oncology is in a ultra-competitive area. I think we have a leadership position, but I think we need to maintain that leadership position. And for the reasons of focus, we decided to create KITE as an independent business unit that will wake up and go to sleep every day thinking about how to be leaders in oncology cell therapy. Now that's not to suggest that, they won't work with the rest of the organization to complement as we know specifically in oncology the combination approach and the multi-science approach is absolutely the way to go. But we need to make sure we secure that leadership in cell therapy, while…

John McHutchison

Management

Completely agree, Dan.

Operator

Operator

Thank you. Our next question comes from the line of Ying Huang from Bank of America Merrill Lynch. Your question please.

Ying Huang

Analyst

Hi. Thanks for taking my questions. Maybe for Daniel. Is there anything you actually want to change in the Gilead organization after two months in the job? And then maybe another one for John McHutchison quickly. You decided to have a collaboration with Novo Nordisk in NASH. How does it compare to the other mechanisms of actions in the market today or on the development today if you look at semaglutide data in NASH? Thank you.

Daniel O'Day

Management

Thanks, Ying. And look let me first say that, I've been incredibly welcomed and very impressed with coming into Gilead. So I think I probably know more of what I don't want to change than what I do want to change after two months in the role. And that is the focus on science. I've been really impressed by the science and the motivation and intelligence of the colleagues at Gilead. I think both the level of expertise that is here in many different areas as well as the intrinsic motivation of our employees is something that I've been deeply, deeply impressed by. So, in terms of what to change, as I said before, I'm still in the process of evaluating the organization looking at pipeline, looking at commercial execution, looking at the organizational structure and people. And I think you would agree with me that, two months is really short period of time to evaluate that which is why I said there are certain things that I'm acting quickly on and won't hesitate to like the KITE decision and there are other things I think I need to learn a little bit more and understand. But it will be an evolution, not a revolution, and it will be based upon good observations, good discussions with the leadership teams in terms of how we progress here, so stay tuned on that. And I think, we as a leadership team and a leadership community here at Gilead with the Board, and we continue to have our outside ears open to investors and to thought leaders and to what our patient needs are. We'll continue the evolution of the company, and I'll be articulating better what my priorities are as I go into the later part of this year, and we'll certainly inform you as I go. So, thank you for the question. And John, will you?

John McHutchison

Management

Yes. We know that Novo Nordisk, Ying, that's a compelling mechanism of action. Novo Nordisk is clearly a leader in the pharmaceutical development of products for patients with diabetes and metabolic syndrome. Mechanism of action is not necessarily directly related to NASH, but it has many of the effects you would want to see in patients with NASH. And additionally and importantly, as well as all those other metabolic benefits in terms of glucose control influence secretion and so forth, as a weight loss component to this drug and a significant weight loss component. And that weight loss component, we think is very compelling for us to explore with our other mechanisms of action that are really focusing on different and separate drivers of NASH at the Genesis. So we believe it's a very exciting and a very important collaboration. Novo Nordisk brings a lot of people and a lot of depth of knowledge about metabolic syndrome to the table, whilst we bring a lot of expertise in liver disease. So it's a wonderful collaboration that we're just starting, and looking forward to. So we will combine a semaglutide without FXR agonists and our ACC drugs as well, and that will be the initial clinical collaboration.

Operator

Operator

Thank you. Our next question comes from the line of Umer Raffat from Evercore. Your question, please.

Umer Raffat

Analyst

Hi. Thank you so much for taking my question, and welcome again Dan, for your first Gilead call. I wanted to keep it fairly high level today. I'll maybe just ask Dan. Do you see Gilead as growing top line into 2020s? And also, what are the biggest risks and the biggest opportunities that you see at Gilead currently? Daniel O’Day: Thanks a lot Umer for the warm welcome again. I really appreciate, and look forward to working with all of you, and obviously articulating my views and visions for the company as I go. It is definitely premature to talk about sales in 2020 at this stage. In fact, in the first two months, I've really been focusing, as you know, on pipeline and understanding our current commercial delivery. We will over the coming months of course, in the natural process of thing start to digest the progress that we have for this year, the opportunities we have for next year and put those into some ideas of a plan. So I think it's a bit too premature for that. What I can assure you is that we'll give you a sense for that much later in the year. At this stage, I mean, maybe just to add a little additional color to that from the way that I see the business today. I see the strengths in HIV clearly as a real foundation of course of Gilead and a strong and growing business. Laura mentioned the progress in Biktarvy. Both Laura and John talked about the really good data on the Descovy and the opportunity there with the DISCOVER trial. So, I do see good strength in the HIV business. I see the opportunity that HCV is much more predictable at this stage and a much smaller part…

Operator

Operator

Thank you. Your next question comes from the line of Phil Nadeau from Cowen and Company. Your question please.

Phil Nadeau

Analyst

Good afternoon. Thanks for taking my question. Robin let me add my congratulations on the announcement of your retirement. Dan, a question for you actually on HIV just to focus their. Gilead's clearly been a leader in HIV treatment for almost two decades. But arguably you fall behind in the development of nucleotide-sparing regimens and long-acting regimens, so you brought fresh eyes to looking at your HIV portfolio. How do you see the treatment of HIV evolving over the next five to 10 years? And do you feel like Gilead's HIV pipeline has all the programs that it needs to stay competitive over that period? Daniel O’Day: Thanks, Phil and I welcome John and Laura to feed in on this as well, but I'll give you my top line take first. And that is that there's no doubt that Gilead is the leader in HIV has been for a long time and to your point, so we need to make sure that we continue to have the most significant next advance for patients and that's certainly been the case for TAF. From TAF the regimens and to the Descovy regimens, and now of course with the PrEP data and certainly there's lots more that we can do in improving the patient experience in HIV including long acting as you mentioned and other approaches. So I think there's a very comprehensive life cycle plan around this and I think that thinking this got into this in terms of making sure that the next generation programs like a long acting are something that are going to be well received by the patients that are convenient easy to take and really allow for if you like the next best advance from a daily oral medicine, which is let's face it the highly convenient to begin with. So I think they really scrutinize the target profile well and I think the science that's growing on here is well-positioned to continue to take the next meaningful advances for patients into the future. But I would ask John if you want to feed in on this, great?

John McHutchison

Management

Sure. Thanks, Phil. Phil we have led the field of HIV therapeutic development for over a decade. And one of the critical components of that approach and our success has been no resistance. And that has been achieved with effective three drug regimens. So, for example, with all the Biktarvy studies as you know we have no resistance through week 96, which is a critical advantage for anybody. You can't afford to increase the fragility of a regimen by decreasing or diminishing or cutting out one of the components, and theoretically or not theoretically increasing the risk of resistance. So that's very important. Now two drug regimens with adherence is potentially not so important such as an effective long-acting regimen is actually one of our critical programs internally. And we believe that our ultimate goal with the long-acting regimen should be a subcutaneous at-home small volume, non-painful injection that's probably got two components to it, but it won't have that adherence issue to it and we'd like to be giving it every three months. That would be a great advance for patients as well. And in terms of our other activities in HIV, we have many cure programs as you know. We also have programs for those most in need in terms of the highly resistant groups of patients and then of course we have all of our PrEP programs as we discussed on the call today. So we are very much laser-focused on maintaining our leadership position scientifically and for patients with HIV and preventing HIV by all of these initiatives. So I think the issue of two versus three drug regimens has to be put in context of the decades of history of this disease and where the long-acting ultimate goal should be.

Operator

Operator

Thank you. Our next question comes from the line of Cory Kasimov from JPMorgan. Your question please.

Cory Kasimov

Analyst

Hey, good afternoon guys, and thank you for taking my question. I also have one on HIV, but more from a near-term commercial standpoint. So basically curious how you're thinking about potential pricing pressures within the category over the near to medium-term from both potential U.S. health care reform as well as competitors entering the space at substantial discounts to Gilead's regimens? Thanks.

Laura Hamill

Management

Thanks for the question. This is Laura. So let me start off with the pricing pressures in the U.S. health care and I assume you're talking about is maybe the protected class with the Medicare population. So let me just address that. We've been actively engaged in a discussion around the protected class and this is the Part D benefit for the senior population. And all along I think what's most important for the senior population is to ensure that they have access to safe and effective medicines that are appropriate for the guidelines. We really want to make sure that there is no prior authorization that impedes rapid treatment and renewal of the long-term treatment for patients. And I think that there's been a significant groundswell across the community of advocacy of people positioned that really believe that it's important for the Medicare population to have access to the HIV regiments that they need and to maintain a protected class. So that's specific to the Medicare population. As it relates to the commercial population, I would say that we're very pleased with the amazing coverage that we've been able to achieve with Biktarvy. Over 90% of the plans have Biktarvy rapidly available. You can see that in the numbers and what we just said in terms of treatment-naïve and switch patient. How quickly patients are moving to Biktarvy and obviously 80% of our overall prescription is coming from a Descovy base backbone. So we don't feel significant pressure on the commercial side as it relates to coverage and access. As it relates to the overall growth that we see as I mentioned, we had a 12% prescription growth year-over-year. And we've continued to maintain double-digit growth for the last couple of years. So, I'm very, very pleased with that.…

Operator

Operator

Thank you. And our final question for today comes from the line of Ronny Gal from Bernstein, your question please? Q – Ronny Gal: Hi. Good afternoon, everybody. And thanks for filling me in. Two there if I can. One, about HCV, I noticed the agreements you just had in the U.K. and the one you had in Louisiana. Can you just explain to us from a financial perspective, how you're thinking about this? There's some implied discount in those contracts. But obviously you're getting access to other patients you wouldn't otherwise. So can you just tell us how you're thinking about this as a strategy? And then, coming back to this issue of HIV pricing I hear you about not raising prices. But Robin, I think you mentioned that with this shift of patients, to government programs you're actually seeing a bit of a net decline. And if we look at the revenue reported and divided by IMS scripts, we are seeing kind of like modest declines year-over-year in your price point. Should that be the baseline assumption going forward? Essentially more people going on those programs. You guys not raising prices. And that's in effect we should see a net price decrease a little bit per year the way the market is looking right now? A – Robin Washington: Yeah, Ronny I'll take that -- the second part of your question. What I was referring to was just a shift relative to when public buyers purchase right. And that's about payer mix right? And typically in Q1 as even the ADAP cycle, we do see that downward shift driven by payer mix. The biggest overall driver of our sequential decline this past quarter however was not pricing at all, it was inventory right. So I just want to…

Operator

Operator

Thank you. This does conclude the question-and-answer session of today's program. I'd like to hand the program back to Sung Lee for any further remarks.

Sung Lee

Management

Thank you, Jonathan. And thank you all for joining us today. We appreciate your continued interest in Gilead. And the team here looks forward to providing you with updates on our future progress.

Operator

Operator

Thank you, ladies and gentlemen, for your participation in today's conference. This does conclude the program. You may now disconnect. Good day.