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125-573: Gilead Sciences, Inc. ( / ˈ ɡ ɪ l i ə d / ) is an American biopharmaceutical company headquartered in Foster City, California , that focuses on researching and developing antiviral drugs used in the treatment of HIV/AIDS , hepatitis B , hepatitis C , influenza , and COVID-19 , including ledipasvir/sofosbuvir and sofosbuvir . Gilead is a member of the Nasdaq-100 and the S&;P 100 . Gilead

250-553: A catalyst . This method is commonly demonstrated in undergraduate teaching labs. Reaction between acetic acid and salicylic acid can also form aspirin but this esterification reaction is reversible and the presence of water can lead to hydrolysis of the aspirin. So, an anhydrous reagent is preferred. Formulations containing high concentrations of aspirin often smell like vinegar because aspirin can decompose through hydrolysis in moist conditions, yielding salicylic and acetic acids. Aspirin, an acetyl derivative of salicylic acid,

375-455: A heart attack . It is generally not recommended for routine use by people with no other health problems, including those over the age of 70. The 2009 Antithrombotic Trialists' Collaboration published in Lancet evaluated the efficacy and safety of low dose aspirin in secondary prevention. In those with prior ischaemic stroke or acute myocardial infarction, daily low dose aspirin was associated with

500-508: A virus to include a desirable piece of genetic material. Viral gene therapies using engineered plant viruses have been proposed to enhance crop performance and promote sustainable production. With the expiration of many patents for blockbuster biologics between 2012 and 2019, the interest in biosimilar production, i.e., follow-on biologics, has increased. Compared to small molecules that consist of chemically identical active ingredients , biologics are vastly more complex and consist of

625-666: A 19% relative risk reduction of serious cardiovascular events (non-fatal myocardial infarction, non-fatal stroke, or vascular death). This did come at the expense of a 0.19% absolute risk increase in gastrointestinal bleeding; however, the benefits outweigh the hazard risk in this case. Data from previous trials have suggested that weight-based dosing of aspirin has greater benefits in primary prevention of cardiovascular outcomes. However, more recent trials were not able to replicate similar outcomes using low dose aspirin in low body weight (<70 kg) in specific subset of population studied i.e. elderly and diabetic population, and more evidence

750-513: A CVD risk estimation and a risk discussion should be done before starting on aspirin, while stating aspirin should be used "infrequently in the routine primary prevention of (atherosclerotic CVD) because of lack of net benefit". As of August 2021 , the European Society of Cardiology made similar recommendations; considering aspirin specifically to patients aged less than 70 at high or very high CVD risk, without any clear contraindications, on

875-658: A Nobel laureate who later became Director of the National Institutes of Health , and Jack Szostak , recipient of the Nobel Prize for Physiology or Medicine in 2009. The company's primary therapeutic focus was in antiviral medicines, a field that piqued Riordan's interest after he contracted dengue fever . Riordan recruited Donald Rumsfeld to join the board of directors in 1988, followed by Benno C. Schmidt, Sr. , Gordon Moore , and George P. Shultz . Riordan tried to recruit Warren Buffett as an investor and board member but

1000-461: A biotechnology company into a pharmaceutical company, acquiring several subsidiaries, though it still relied heavily on contracting to manufacture its drugs. The company continued its growth in the 2010s. However, it came under heavy scrutiny over its business practices, including extremely high pricing of drugs such as Sovaldi and Truvada in the United States relative to production cost and cost in

1125-420: A central role in many biological processes, including inflammation. Aspirin is readily broken down in the body to salicylic acid, which itself has anti-inflammatory, antipyretic, and analgesic effects. In 2012, salicylic acid was found to activate AMP-activated protein kinase , which has been suggested as a possible explanation for some of the effects of both salicylic acid and aspirin. The acetyl portion of

1250-514: A cheaper domestic version. In 1763 he sent a report of his findings to the Royal Society in London. By the nineteenth century, pharmacists were experimenting with and prescribing a variety of chemicals related to salicylic acid , the active component of willow extract. In 1853, chemist Charles Frédéric Gerhardt treated sodium salicylate with acetyl chloride to produce acetylsalicylic acid for

1375-572: A first heart attack or stroke." Primary prevention guidelines from September 2019 made by the American College of Cardiology and the American Heart Association state they might consider aspirin for patients aged 40–69 with a higher risk of atherosclerotic CVD, without an increased bleeding risk, while stating they would not recommend aspirin for patients aged over 70 or adults of any age with an increased bleeding risk. They state

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1500-450: A large proportion of maximum thromboxane A 2 release provoked acutely, with the prostaglandin I 2 synthesis being little affected; however, higher doses of aspirin are required to attain further inhibition. Prostaglandins, local hormones produced in the body, have diverse effects, including the transmission of pain information to the brain, modulation of the hypothalamic thermostat, and inflammation. Thromboxanes are responsible for

1625-521: A licensing agreement with Parion for an epithelial sodium channel inhibitor for the treatment of pulmonary diseases, including cystic fibrosis, chronic obstructive pulmonary disease and bronchiectasis . In 2009, the company acquired CV Therapeutics, Inc. for $ 1.4 billion, bringing Ranexa and Lexiscan into Gilead. Ranexa is a cardiovascular drug used to treat chest pain related to coronary artery disease, with both of these products and pipeline building out Gilead's cardiovascular franchise. Later that year,

1750-506: A massive multi-year expansion of its 17-building headquarters campus in Foster City. By replacing eight one or two-story buildings with seven new structures ranging as tall as 10 stories, Gilead nearly doubled its headquarters real estate footprint from about 620,000 square feet to about 1.2 million square feet. On July 16, 2012, the FDA approved Gilead's Truvada for prevention of HIV infection (it

1875-472: A multitude of subspecies. Due to their heterogeneity and the high process sensitivity, originators and follow-on biosimilars will exhibit variability in specific variants over time. The safety and clinical performance of both originator and biosimilar biopharmaceuticals must remain equivalent throughout their lifecycle. Process variations are monitored by modern analytical tools (e.g., liquid chromatography , immunoassays , mass spectrometry , etc.) and describe

2000-403: A period of five years. Aspirin has also been suggested as a component of a polypill for prevention of cardiovascular disease. Complicating the use of aspirin for prevention is the phenomenon of aspirin resistance. For people who are resistant, aspirin's efficacy is reduced. Some authors have suggested testing regimens to identify people who are resistant to aspirin. As of April 2022 ,

2125-462: A pill's price was as low as $ 4.29. Gilead later combined Sovaldi with other antivirals in single-pill combinations. First, Sovaldi was combined with ledipasvir and marketed as Harvoni . This treatment for hepatitis C cures the patient in 94% to 99% of cases (HCV genotype 1). By 2017, Gilead was reporting drastic drops in Sovaldi revenue from year to year, not only because of pricing pressure but because

2250-575: A price of US$ 133.3 million . Raylo Chemical, based in Edmonton, Alberta , was a wholly-owned subsidiary of Degussa AG , a German company. Raylo Chemical was a custom manufacturer of active pharmaceutical ingredients and advanced intermediates for the pharmaceutical and biopharmaceutical industries. Later in the same year, Gilead acquired Myogen, Inc. for $ 2.5 billion (then its largest acquisition). With two drugs in development (ambrisentan and darusentan), and one marketed product (Flolan) for pulmonary diseases,

2375-442: A single crystal form or polymorph. Until 2005, there was only one proven polymorph of aspirin ( Form I ), though the existence of another polymorph was debated since the 1960s, and one report from 1981 reported that when crystallized in the presence of aspirin anhydride , the diffractogram of aspirin has weak additional peaks. Though at the time it was dismissed as mere impurity, it was, in retrospect, Form II aspirin. Form II

2500-1124: A supply shortage for these products. Institutions housing these biologics, designated as 'banks', often cannot distribute their product to customers effectively. Conversely, banks for reproductive cells are much more widespread and available due to the ease with which spermatozoa and egg cells can be used for fertility treatment. Biopharmaceuticals may be produced from microbial cells (e.g., recombinant E. coli or yeast cultures), mammalian cell lines (see Cell culture ) and plant cell cultures (see Plant tissue culture ) and moss plants in bioreactors of various configurations, including photo-bioreactors . Important issues of concern are cost of production (low-volume, high-purity products are desirable) and microbial contamination (by bacteria , viruses , mycoplasma ). Alternative platforms of production which are being tested include whole plants ( plant-made pharmaceuticals ). A potentially controversial method of producing biopharmaceuticals involves transgenic organisms, particularly plants and animals that have been genetically modified to produce drugs. This production

2625-503: A trademark clearance issue with a California nonprofit organization that was already using the word Gilead in its name. He had first heard of the Balm of Gilead when he read Lanford Wilson 's play Balm in Gilead while in medical school, then learned that naturally occurring acetylsalicylic acid ( aspirin ) had been found in modern times in a willow tree species from that part of that world, and

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2750-404: A unique design space for each biologic. Biosimilars require a different regulatory framework compared to small-molecule generics. Legislation in the 21st century has addressed this by recognizing an intermediate ground of testing for biosimilars. The filing pathway requires more testing than for small-molecule generics, but less testing than for registering completely new therapeutics. In 2003,

2875-785: A wide range of biological products in medicine. However, in most cases, the term is used more restrictively for a class of therapeutics (either approved or in development) that are produced using biological processes involving recombinant DNA technology. These medications are usually one of three types: Biologics as a class of medications in this narrower sense have had a profound impact on many medical fields, primarily rheumatology and oncology , but also cardiology , dermatology , gastroenterology , neurology , and others. In most of these disciplines, biologics have added major therapeutic options for treating many diseases, including some for which no effective therapies were available, and others where previously existing therapies were inadequate. However,

3000-616: Is pharmaceutics that works with biopharmaceuticals. Biopharmacology is the branch of pharmacology that studies biopharmaceuticals. Specialty drugs , a recent classification of pharmaceuticals, are high-cost drugs that are often biologics. The European Medicines Agency uses the term advanced therapy medicinal products (ATMPs) for medicines for human use that are "based on genes, cells, or tissue engineering", including gene therapy medicines, somatic-cell therapy medicines, tissue-engineered medicines, and combinations thereof. Within EMA contexts,

3125-422: Is 0.1–0.2 L/kg. Acidosis increases the volume of distribution because of enhancement of tissue penetration of salicylates. As much as 80% of therapeutic doses of salicylic acid is metabolized in the liver . Conjugation with glycine forms salicyluric acid , and with glucuronic acid to form two different glucuronide esters. The conjugate with the acetyl group intact is referred to as the acyl glucuronide ;

3250-453: Is a significant risk for its investor due to production failure or scrutiny from regulatory bodies based on perceived risks and ethical issues. Biopharmaceutical crops also represent a risk of cross-contamination with non-engineered crops, or crops engineered for non-medical purposes. One potential approach to this technology is the creation of a transgenic mammal that can produce the biopharmaceutical in its milk, blood, or urine. Once an animal

3375-423: Is a white, crystalline, weakly acidic substance that melts at 136 °C (277 °F), and decomposes around 140 °C (284 °F). Its acid dissociation constant (p K a ) is 3.5 at 25 °C (77 °F). Polymorphism , or the ability of a substance to form more than one crystal structure , is important in the development of pharmaceutical ingredients. Many drugs receive regulatory approval for only

3500-459: Is also used long-term to help prevent further heart attacks , ischaemic strokes , and blood clots in people at high risk. For pain or fever, effects typically begin within 30 minutes. Aspirin works similarly to other NSAIDs but also suppresses the normal functioning of platelets . One common adverse effect is an upset stomach . More significant side effects include stomach ulcers , stomach bleeding , and worsening asthma . Bleeding risk

3625-496: Is called dual antiplatelet therapy (DAPT). Duration of DAPT was advised in the United States and European Union guidelines after the CURE and PRODIGY studies. In 2020, the systematic review and network meta-analysis from Khan et al. showed promising benefits of short-term (< 6 months) DAPT followed by P2Y12 inhibitors in selected patients, as well as the benefits of extended-term (> 12 months) DAPT in high risk patients. In conclusion,

3750-432: Is classified as an esterification reaction. Salicylic acid is treated with acetic anhydride , an acid derivative, causing a chemical reaction that turns salicylic acid's hydroxyl group into an ester group (R-OH → R-OCOCH 3 ). This process yields aspirin and acetic acid , which is considered a byproduct of this reaction. Small amounts of sulfuric acid (and occasionally phosphoric acid ) are almost always used as

3875-478: Is downregulated with respect to thromboxane levels, as COX-1 in platelets is unaffected. Thus, the protective anticoagulative effect of PGI 2 is removed, increasing the risk of thrombus and associated heart attacks and other circulatory problems. Since platelets have no DNA, they are unable to synthesize new COX-1 once aspirin has irreversibly inhibited the enzyme, an important difference as compared with reversible inhibitors. Furthermore, aspirin, while inhibiting

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4000-521: Is greater among those who are older, drink alcohol , take other NSAIDs, or are on other blood thinners . Aspirin is not recommended in the last part of pregnancy . It is not generally recommended in children with infections because of the risk of Reye syndrome . High doses may result in ringing in the ears . A precursor to aspirin found in the bark of the willow tree (genus Salix ) has been used for its health effects for at least 2,400 years. In 1853, chemist Charles Frédéric Gerhardt treated

4125-404: Is increased from 5 to 8. The use of urinary alkalinization exploits this particular aspect of salicylate elimination. It was found that short-term aspirin use in therapeutic doses might precipitate reversible acute kidney injury when the patient was ill with glomerulonephritis or cirrhosis . Aspirin for some patients with chronic kidney disease and some children with congestive heart failure

4250-475: Is ionized. Owing to the formation of concretions, aspirin is absorbed much more slowly during overdose, and plasma concentrations can continue to rise for up to 24 hours after ingestion. About 50–80% of salicylate in the blood is bound to human serum albumin , while the rest remains in the active, ionized state; protein binding is concentration-dependent. Saturation of binding sites leads to more free salicylate and increased toxicity. The volume of distribution

4375-424: Is more likely to cause gastrointestinal bleeding . Aspirin is generally ineffective for those pains caused by muscle cramps , bloating , gastric distension , or acute skin irritation. As with other NSAIDs, combinations of aspirin and caffeine provide slightly greater pain relief than aspirin alone. Effervescent formulations of aspirin relieve pain faster than aspirin in tablets, which makes them useful for

4500-477: Is most effective at stopping migraines when they are first beginning. Like its ability to control pain, aspirin's ability to control fever is due to its action on the prostaglandin system through its irreversible inhibition of COX . Although aspirin's use as an antipyretic in adults is well established, many medical societies and regulatory agencies, including the American Academy of Family Physicians ,

4625-494: Is no overall clinical benefit (12% decrease in risk of ischaemic events v/s 29% increase in GI bleeding) of low dose aspirin in preventing the serious vascular events over a period of 7.4 years. Similarly, the results of the ARRIVE study also showed no benefit of same dose of aspirin in reducing the time to first cardiovascular outcome in patients with moderate risk of cardiovascular disease over

4750-426: Is outside the U.S. and is unavailable for acquisitions unless Gilead pays U.S. tax on it, though it could borrow against it. Gilead would benefit from proposals to let companies repatriate offshore capital with minimal further taxation. Gilead's Entospletinib has shown a 90% complete response rate for MLL type acute myeloid leukaemia (AML). Several mass tort lawsuits have been filed against Gilead alleging that

4875-593: Is produced, typically using the pronuclear microinjection method, it becomes efficacious to use cloning technology to create additional offspring that carry the favorable modified genome. The first such drug manufactured from the milk of a genetically modified goat was ATryn , but marketing permission was blocked by the European Medicines Agency in February 2006. This decision was reversed in June 2006 and approval

5000-414: Is proposed that this aspirin-triggered transition of COX-2 from cyclooxygenase to lipoxygenase activity and the consequential formation of specialized proresolving mediators contributes to the anti-inflammatory effects of aspirin. Aspirin has been shown to have at least three additional modes of action. It uncouples oxidative phosphorylation in cartilaginous (and hepatic) mitochondria, by diffusing from

5125-565: Is removed. Form IV was reported in 2017. It is stable at ambient conditions. In 1971, British pharmacologist John Robert Vane , then employed by the Royal College of Surgeons in London, showed aspirin suppressed the production of prostaglandins and thromboxanes . For this discovery he was awarded the 1982 Nobel Prize in Physiology or Medicine , jointly with Sune Bergström and Bengt Ingemar Samuelsson . Aspirin's ability to suppress

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5250-457: Is required to study the effect of high dose aspirin in high body weight (≥70 kg). After percutaneous coronary interventions (PCIs), such as the placement of a coronary artery stent , a U.S. Agency for Healthcare Research and Quality guideline recommends that aspirin be taken indefinitely. Frequently, aspirin is combined with an ADP receptor inhibitor , such as clopidogrel , prasugrel , or ticagrelor to prevent blood clots . This

5375-477: The Fortune 500 . Charitable donations to HIV/AIDS and liver disease organizations totaled over 440 million in 2015. In August 2017, the company announced it would acquire Kite Pharma for $ 11.9 billion, equating to $ 180 cash per share, a 29% premium over the closing price of the shares. The deal was Gilead's entry into the cell therapy market and added a chimeric antigen receptor T cell ( CAR-T ) therapy candidate to

5500-454: The American Academy of Pediatrics , and the Food and Drug Administration , strongly advise against using aspirin for the treatment of fever in children because of the risk of Reye's syndrome , a rare but often fatal illness associated with the use of aspirin or other salicylates in children during episodes of viral or bacterial infection. Because of the risk of Reye's syndrome in children, in 1986,

5625-497: The Avian flu pandemic scare, Gilead Sciences' revenue from Tamiflu almost quadrupled to $ 44.6m as more than 60 national governments stockpiled the antiviral drug, though the firm had made a loss in 2003 before concern about the flu started. As stocks soared, US Defense Secretary and Pentagon chief Donald Rumsfeld sold shares of the company, receiving more than $ 5 million in capital gains, while still maintaining up to $ 25m-worth of shares by

5750-581: The European Medicines Agency introduced an adapted pathway for biosimilars, termed similar biological medicinal products . This pathway is based on a thorough demonstration of comparability of the product to an existing approved product. Within the United States, the Patient Protection and Affordable Care Act of 2010 created an abbreviated approval pathway for biological products shown to be biosimilar to, or interchangeable with, an FDA-licensed reference biological product. Researchers are optimistic that

5875-544: The International Classification of Headache Disorders distinguishes between tension headache (the most common), migraine, and cluster headache . Aspirin or other over-the-counter analgesics are widely recognized as effective for the treatment of tension headaches. Aspirin, especially as a component of an aspirin/paracetamol/caffeine combination , is considered a first-line therapy in the treatment of migraine, and comparable to lower doses of sumatriptan . It

6000-615: The United States Preventive Services Task Force (USPSTF) determined that there was a "small net benefit" for patients aged 40–59 with a 10% or greater 10-year cardiovascular disease (CVD) risk, and "no net benefit" for patients aged over 60. Determining the net benefit was based on balancing the risk reduction of taking aspirin for heart attacks and ischaemic strokes, with the increased risk of gastrointestinal bleeding , intracranial bleeding , and hemorrhagic strokes . Their recommendations state that age changes

6125-417: The alkali metals . It is stable in dry air, but gradually hydrolyses in contact with moisture to acetic and salicylic acids . In solution with alkalis, the hydrolysis proceeds rapidly and the clear solutions formed may consist entirely of acetate and salicylate. Like flour mills , factories producing aspirin tablets must control the amount of the powder that becomes airborne inside the building, because

6250-445: The 2011 acquisition of Pharmasset. In 2013, the FDA approved this drug, under the trade name Sovaldi, as a treatment for the hepatitis C virus . Forbes magazine ranked Gilead its number 4 drug company, citing a market capitalization of US$ 113 billion and stock appreciation of 100%, and describing their 2011 purchase of Pharmasset for $ 11 billion as "one of the best pharma acquisitions ever". Deutsche Bank estimated Sovaldi sales in

6375-575: The Biologics and Genetic Therapies Directorate within Health Canada . Aspirin Aspirin , also known as acetylsalicylic acid ( ASA ), is a nonsteroidal anti-inflammatory drug (NSAID) used to reduce pain , fever , and inflammation , and as an antithrombotic . Specific inflammatory conditions that aspirin is used to treat include Kawasaki disease , pericarditis , and rheumatic fever . Aspirin

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6500-583: The Gilead corporate campus in Foster City had expanded to "seven low-slung sand-colored buildings around a tiny lake on which ducks happily paddle." Like many startups, Gilead originally leased its space, but in 2004, the company paid $ 123 million to buy all its headquarters buildings from its landlords. However, even as Gilead developed its ability to distribute and sell its own drugs, it remained distinct from most pharmaceutical companies in terms of its strong reliance on subcontracting most of its manufacturing to contract manufacturing organizations . In 2004, during

6625-456: The US Food and Drug Administration (FDA) required labeling on all aspirin-containing medications advising against its use in children and teenagers. Aspirin is used as an anti-inflammatory agent for both acute and long-term inflammation , as well as for the treatment of inflammatory diseases, such as rheumatoid arthritis . Aspirin is an important part of the treatment of those who have had

6750-501: The United States, with more than 16   million prescriptions. In 1897, scientists at the Bayer company began studying acetylsalicylic acid as a less-irritating replacement medication for common salicylate medicines. By 1899, Bayer had named it "Aspirin" and was selling it around the world. Aspirin's popularity grew over the first half of the 20th century, leading to competition between many brands and formulations. The word Aspirin

6875-559: The ability of COX-2 to form pro-inflammatory products such as the prostaglandins , converts this enzyme's activity from a prostaglandin-forming cyclooxygenase to a lipoxygenase -like enzyme: aspirin-treated COX-2 metabolizes a variety of polyunsaturated fatty acids to hydroperoxy products which are then further metabolized to specialized proresolving mediators such as the aspirin-triggered lipoxins (15-epilipoxin-A4/B4), aspirin-triggered resolvins , and aspirin-triggered maresins . These mediators possess potent anti-inflammatory activity. It

7000-549: The acquisition of Myogen has solidified Gilead's position in this therapeutic arena. Under an agreement with GlaxoSmithKline , Myogen marketed Flolan ( epoprostenol sodium ) in the United States for the treatment of primary pulmonary hypertension . Additionally, Myogen was developing (in Phase 3 studies) darusentan, also an endothelin receptor antagonist, for the potential treatment of resistant hypertension . Gilead expanded its move into respiratory therapeutics in 2007 by entering into

7125-436: The advent of biologic therapeutics has also raised complex regulatory issues (see below), and significant pharmacoeconomic concerns because the cost for biologic therapies has been dramatically higher than for conventional (pharmacological) medications. This factor has been particularly relevant since many biological medications are used to treat chronic diseases , such as rheumatoid arthritis or inflammatory bowel disease, or for

7250-719: The aggregation of platelets that form blood clots . Heart attacks are caused primarily by blood clots, and low doses of aspirin are seen as an effective medical intervention to prevent a second acute myocardial infarction. At least two different types of cyclooxygenases , COX-1 and COX-2 , are acted on by aspirin. Aspirin irreversibly inhibits COX-1 and modifies the enzymatic activity of COX-2. COX-2 normally produces prostanoids , most of which are proinflammatory. Aspirin-modified COX-2 (aka prostaglandin-endoperoxide synthase 2 or PTGS2) produces epi-lipoxins , most of which are anti-inflammatory. Newer NSAID drugs, COX-2 inhibitors (coxibs), have been developed to inhibit only COX-2, with

7375-530: The aspirin molecule has its own targets. Acetylation of cellular proteins is a well-established phenomenon in the regulation of protein function at the post-translational level. Aspirin is able to acetylate several other targets in addition to COX isoenzymes. These acetylation reactions may explain many hitherto unexplained effects of aspirin. Aspirin is produced in many formulations, with some differences in effect. In particular, aspirin can cause gastrointestinal bleeding , and formulations are sought which deliver

7500-522: The benefits of aspirin while mitigating harmful bleeding. Formulations may be combined (e.g., buffered + vitamin C). Acetylsalicylic acid is a weak acid , and very little of it is ionized in the stomach after oral administration. Acetylsalicylic acid is quickly absorbed through the cell membrane in the acidic conditions of the stomach. The increased pH and larger surface area of the small intestine causes aspirin to be absorbed more slowly there, as more of it

7625-560: The biopharmaceutical industry, generating 37 percent of the total number of granted patents worldwide; however, there is still a large margin for growth and innovation within the industry. Revisions to the current IP system to ensure greater reliability for R&D (research and development) investments is a prominent topic of debate in the US as well. Blood products and other human-derived biologics such as breast milk have highly regulated or very hard-to-access markets; therefore, customers generally face

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7750-415: The body, which have been shown in mice to have an independent mechanism of reducing inflammation. This reduced leukocyte adhesion is an important step in the immune response to infection; however, evidence is insufficient to show aspirin helps to fight infection. More recent data also suggest salicylic acid and its derivatives modulate signalling through NF-κB . NF-κB, a transcription factor complex, plays

7875-773: The business announced it would acquire German biotech, MYR GmbH, for €1.15 billion plus up to a further €300 million. MYR focuses on the treatment of chronic hepatitis delta virus . On August 11, 2021, U.S. Senator Rand Paul disclosed that his wife Kelley Paul had purchased a stake in Gilead Sciences on February 26, 2020. In November 2021, the company was added to the Dow Jones Sustainability World Index . In January 2022, Gilead pulled its cancer drug Zydelig (idelalisib) from its accelerated approval in relapsed follicular B-cell non-Hodgkin lymphoma (FL) and relapsed small lymphocytic leukemia (SLL). In September,

8000-553: The company acquired Calistoga Pharmaceuticals for US$ 375 million ($ 225 million plus milestone payments). The acquisition boosted Gilead's oncology and inflammation areas. Later that year, Gilead made its most important acquisition – and by then most expensive – with the US$ 10.4 billion purchase of Pharmasset , Inc. This transaction helped cement Gilead as the leader in treatment of the hepatitis C virus by giving it control of sofosbuvir (see below). In October 2011, Gilead broke ground on

8125-442: The company announced it would acquire Forty Seven Inc. for $ 95.50 a share ($ 4.9 billion in total). On April 7, 2020, Gilead completed acquisition of Forty Seven, Inc. for "$ 95.50 per share, net to the seller in cash, without interest, or approximately $ 4.9 billion in the aggregate." In June 2020, Bloomberg reported that AstraZeneca Plc had made a preliminary approach to Gilead for a potential merger, worth almost $ 240 billion. In

8250-513: The company completed its acquisition of MiroBio for $ 405 million. In February 2023, the business, through Kite Pharma completed its acquisition of Tmunity Therapeutics In May, the business announced it would acquire XinThera and its small molecule inhibitors. In February 2024, the company acquired CymaBay Therapeutics ,and in September, paid Genesis Therapeutics $ 35 million for AI-based drug discovery work. The drug sofosbuvir had been part of

8375-672: The company deliberately delayed development of antiretroviral drugs based on tenofovir alafenamide fumarate (TAF) in order to maximize profits from previous-generation medications containing tenofovir disoproxil fumarate (TDF) . Plaintiffs allege that Gilead suspended TAF in 2004 despite clear evidence indicating that TAF-based medications were safer than TDF, a compound whose long-term use was associated with adverse side effects such as nephrotoxicity and bone density loss. Biopharmaceutical Terminology surrounding biopharmaceuticals varies between groups and entities, with different terms referring to different subsets of therapeutics within

8500-457: The company in-licensed a group of nucleotide compounds including tenofovir . Riordan later recalled that Gilead's first decade as a startup was an extremely stressful experience for him, as a young venture capitalist serving for the first time as the founder, chairman, and chief executive officer of his own biotech company. The new company had no products and very little income, and narrowly escaped going out of business on several occasions: "It

8625-454: The company made a trio of acquisitions: In 2016, the company acquired Nimbus Apollo, Inc. for $ 400 million, giving Gilead control of the compound NDI-010976 (an ACC inhibitor) and other preclinical ACC inhibitors for the treatment of non-alcoholic steatohepatitis and for the potential treatment of hepatocellular carcinoma . Also in 2016, the company was named the most generous company on the 2016 Fortune list of The Most Generous Companies of

8750-469: The company was named one of the Fastest Growing Companies by Fortune . In 2010, the company acquired CGI Pharmaceuticals for $ 120 million, expanding Gilead's research expertise into kinase biology and chemistry. Later that year, the company acquired Arresto Biosciences, Inc. for $ 225 million, obtaining developmental-stage research for treating fibrotic diseases and cancer. In February 2011,

8875-462: The company's portfolio. By 2022 this acquisition had led to two marketed products for lymphoma: Yescarta and Tecartus . In November, the company announced it will acquire Cell Design Labs for up to $ 567 million, after it indirectly acquired a stake of 12.2% via the Kite Pharma deal. On May 9, 2019, the U.S. Department of Health and Human Services announced that Gilead Sciences will donate Truvada,

9000-503: The company: Peter Dervan of Caltech , Doug Melton of Harvard , and Harold M. Weintraub of the Fred Hutchinson Cancer Research Center , along with H. Dubose Montgomery, one of Menlo Ventures founders. Riordan served as CEO from the company's founding until 1996. Menlo Ventures subsequently made the first investment in Gilead of $ 2 million. Riordan also recruited scientific advisers, including Harold Varmus ,

9125-400: The deacetylated conjugate is the phenolic glucuronide . These metabolic pathways have only a limited capacity. Small amounts of salicylic acid are also hydroxylated to gentisic acid . With large salicylate doses, the kinetics switch from first-order to zero-order, as metabolic pathways become saturated and renal excretion becomes increasingly important. Salicylates are excreted mainly by

9250-608: The developing world. In June 1987, Gilead Sciences was originally founded under the name Oligogen by Michael L. Riordan, a medical doctor. Riordan graduated from Washington University in St. Louis , the Johns Hopkins School of Medicine , and the Harvard Business School . The idea for Gilead began as a research project at Menlo Ventures , where Michael was an associate. Three scientific advisers worked with Riordan to create

9375-426: The drug is released, it will still be monitored for performance and safety risks. The manufacture process must satisfy the FDA's "Good Manufacturing Practices", which are typically manufactured in a cleanroom environment with strict limits on the amount of airborne particles and other microbial contaminants that may alter the efficacy of the drug. In Canada , biologics (and radiopharmaceuticals) are reviewed through

9500-433: The end of the year. Sales of Tamiflu almost quadrupled again in 2005, to $ 161.6m, during which time the share price tripled. A 2005 report showed that, in all, Rumsfeld owned shares worth up to $ 95.9m, from which he got an income of up to $ 13m. In 2006, the company acquired Corus Pharma, Inc. for $ 365 million. The acquisition of Corus signaled Gilead's entry into the respiratory arena. Corus was developing aztreonam lysine for

9625-452: The first time; in the second half of the 19th century, other academic chemists established the compound's chemical structure and devised more efficient methods of synthesis. In 1897, scientists at the drug and dye firm Bayer began investigating acetylsalicylic acid as a less-irritating replacement for standard common salicylate medicines, and identified a new way to synthesize it. That year, Felix Hoffmann (or Arthur Eichengrün ) of Bayer

9750-409: The formation of thromboxane A 2 in platelets, producing an inhibitory effect on platelet aggregation during the lifetime of the affected platelet (8–9 days). This antithrombotic property makes aspirin useful for reducing the incidence of heart attacks in people who have had a heart attack, unstable angina, ischemic stroke or transient ischemic attack. 40   mg of aspirin a day is able to inhibit

9875-419: The general biopharmaceutical category. Some regulatory agencies use the terms biological medicinal products or therapeutic biological product to refer specifically to engineered macromolecular products like protein- and nucleic acid -based drugs , distinguishing them from products like blood, blood components, or vaccines, which are usually extracted directly from a biological source. Biopharmaceutics

10000-427: The half-life becomes much longer (15 h to 30 h), because the biotransformation pathways concerned with the formation of salicyluric acid and salicyl phenolic glucuronide become saturated. Renal excretion of salicylic acid becomes increasingly important as the metabolic pathways become saturated, because it is extremely sensitive to changes in urinary pH. A 10- to 20-fold increase in renal clearance occurs when urine pH

10125-441: The hydrogen bonds formed by the carboxylic acid groups, both polymorphs form identical dimer structures. The aspirin polymorphs contain identical 2-dimensional sections and are therefore more precisely described as polytypes. Pure Form II aspirin could be prepared by seeding the batch with aspirin anhydrate in 15% weight. Form III was reported in 2015 by compressing form I above 2 GPa, but it reverts back to Form I when pressure

10250-423: The inner membrane space as a proton carrier back into the mitochondrial matrix, where it ionizes once again to release protons. Aspirin buffers and transports the protons. When high doses are given, it may actually cause fever, owing to the heat released from the electron transport chain, as opposed to the antipyretic action of aspirin seen with lower doses. In addition, aspirin induces the formation of NO-radicals in

10375-638: The intellectual property rights. Today, aspirin is a generic trademark in many countries. Aspirin, with a capital "A", remains a registered trademark of Bayer in Germany, Canada, Mexico, and in over 80 other countries, for acetylsalicylic acid in all markets, but using different packaging and physical aspects for each. Aspirin is used in the treatment of a number of conditions, including fever, pain, rheumatic fever , and inflammatory conditions, such as rheumatoid arthritis , pericarditis , and Kawasaki disease . Lower doses of aspirin have also been shown to reduce

10500-447: The intent to reduce the incidence of gastrointestinal side effects. Several COX-2 inhibitors, such as rofecoxib (Vioxx), have been withdrawn from the market, after evidence emerged that COX-2 inhibitors increase the risk of heart attack and stroke. Endothelial cells lining the microvasculature in the body are proposed to express COX-2, and, by selectively inhibiting COX-2, prostaglandin production (specifically, PGI 2 ; prostacyclin)

10625-502: The introduction of biosimilars will reduce medical expenses to patients and the healthcare system. When a new biopharmaceutical is developed, the company will typically apply for a patent , which is a grant to exclusive manufacturing rights. This is the primary means by which the drug developer can recover the investment cost for development of the biopharmaceutical. The patent laws in the United States and Europe differ somewhat on

10750-412: The kidneys as salicyluric acid (75%), free salicylic acid (10%), salicylic phenol (10%), and acyl glucuronides (5%), gentisic acid (< 1%), and 2,3-dihydroxybenzoic acid . When small doses (less than 250   mg in an adult) are ingested, all pathways proceed by first-order kinetics, with an elimination half-life of about 2.0 h to 4.5 h. When higher doses of salicylate are ingested (more than 4 g),

10875-438: The last decades of the 20th century, and remain strong in the 21st century with widespread use as a preventive treatment for heart attacks and strokes . Bayer lost its trademark for Aspirin in the United States and some other countries in actions taken between 1918 and 1921 because it had failed to use the name for its own product correctly and had for years allowed the use of "Aspirin" by other manufacturers without defending

11000-497: The medicine sodium salicylate with acetyl chloride to produce acetylsalicylic acid for the first time. Over the next 50 years, other chemists, mostly of the German company Bayer , established the chemical structure and devised more efficient production methods. Felix Hoffmann (or Arthur Eichengrün ) of Bayer was the first to produce acetylsalicylic acid in a pure, stable form in 1897. By 1899, Bayer had dubbed this drug Aspirin and

11125-609: The mid-eighteenth century after the Rev Edward Stone of Chipping Norton , Oxfordshire, noticed that the bitter taste of willow bark resembled the taste of the bark of the cinchona tree, known as " Peruvian bark ", which was used successfully in Peru to treat a variety of ailments. Stone experimented with preparations of powdered willow bark on people in Chipping Norton for five years and found it to be as effective as Peruvian bark and

11250-423: The number of suitable patients decreased. Later single-pill combinations were Epclusa (with velpatasvir ) and Vosevi (with velpatasvir and voxilaprevir ). For the fiscal year 2017, Gilead Sciences reported earnings of US$ 4.628 billion and annual revenue of US$ 26.107 billion, a decline of 14.1% over the previous fiscal cycle. Gilead Sciences's shares traded at over $ 70 per share, and its market capitalization

11375-416: The only drug approved to prevent infection with H.I.V., for free to 200,000 patients annually for 11 years. On December 3, 2019, HHS explained how the government would distribute the donated drugs. HHS Secretary Alex Azar explained that the U.S. government will pay Gilead $ 200 per bottle for 30 pills for costs associated with getting the drug from factories into the eventual hands of patients. In March 2020,

11500-781: The optimal duration of DAPT after PCIs should be personalized after outweighing each patient's risks of ischemic events and risks of bleeding events with consideration of multiple patient-related and procedure-related factors. Moreover, aspirin should be continued indefinitely after DAPT is complete. The status of the use of aspirin for the primary prevention in cardiovascular disease is conflicting and inconsistent, with recent changes from previously recommending it widely decades ago, and that some referenced newer trials in clinical guidelines show less of benefit of adding aspirin alongside other anti-hypertensive and cholesterol lowering therapies. The ASCEND study demonstrated that in high-bleeding risk diabetics with no prior cardiovascular disease, there

11625-555: The powder-air mixture can be explosive . The National Institute for Occupational Safety and Health (NIOSH) has set a recommended exposure limit in the United States of 5   mg/m (time-weighted average). In 1989, the Occupational Safety and Health Administration (OSHA) set a legal permissible exposure limit for aspirin of 5   mg/m , but this was vacated by the AFL-CIO v. OSHA decision in 1993. The synthesis of aspirin

11750-617: The production of prostaglandins and thromboxanes is due to its irreversible inactivation of the cyclooxygenase (COX; officially known as prostaglandin-endoperoxide synthase, PTGS) enzyme required for prostaglandin and thromboxane synthesis. Aspirin acts as an acetylating agent where an acetyl group is covalently attached to a serine residue in the active site of the COX enzyme ( Suicide inhibition ). This makes aspirin different from other NSAIDs (such as diclofenac and ibuprofen ), which are reversible inhibitors. Low-dose aspirin use irreversibly blocks

11875-483: The production process and its control. For example: In the United States , biologics are licensed through the biologics license application (BLA), then submitted to and regulated by the FDA's Center for Biologics Evaluation and Research (CBER) whereas drugs are regulated by the Center for Drug Evaluation and Research . Approval may require several years of clinical trials , including trials with human volunteers. Even after

12000-408: The proliferation of aspirin brands and products. Aspirin's popularity declined after the development of acetaminophen/paracetamol in 1956 and ibuprofen in 1962. In the 1960s and 1970s, John Vane and others discovered the basic mechanism of aspirin's effects, while clinical trials and other studies from the 1960s to the 1980s established aspirin's efficacy as an anti-clotting agent that reduces

12125-458: The requirements for a patent, with the European requirements perceived as more difficult to satisfy. The total number of patents granted for biopharmaceuticals has risen significantly since the 1970s. In 1978 the total patents granted was 30. This had climbed to 15,600 in 1995, and by 2001 there were 34,527 patent applications. In 2012 the US had the highest IP (Intellectual Property) generation within

12250-469: The risk of clotting diseases. The initial large studies on the use of low-dose aspirin to prevent heart attacks that were published in the 1970s and 1980s helped spur reform in clinical research ethics and guidelines for human subject research and US federal law, and are often cited as examples of clinical trials that included only men, but from which people drew general conclusions that did not hold true for women. Aspirin sales revived considerably in

12375-447: The risk of death from a heart attack , or the risk of stroke in people who are at high risk or who have cardiovascular disease, but not in elderly people who are otherwise healthy. There is evidence that aspirin is effective at preventing colorectal cancer , though the mechanisms of this effect are unclear. Aspirin is an effective analgesic for acute pain, although it is generally considered inferior to ibuprofen because aspirin

12500-578: The risk of the medicine, with the magnitude of the benefit of aspirin coming from starting at a younger age, while the risk of bleeding, while small, increases with age, particular for adults over 60, and can be compounded by other risk factors such as diabetes and a history of gastrointestinal bleeding. As a result, the USPSTF suggests that "people ages 40 to 59 who are at higher risk for CVD should decide with their clinician whether to start taking aspirin; people 60 or older should not start taking aspirin to prevent

12625-401: The same month, the company announced it would acquire a 49.9% stake in privately held Pionyr Immunotherapeutics Inc for $ 275 million. In September 2020, Gilead announced it had reached a deal to acquire Immunomedics for $ 21 billion ($ 88 per share), gaining control of the cancer treatment Trodelvy ( Sacituzumab govitecan -hziy) – a first-in-class Trop-2 antibody-drug conjugate. In December,

12750-474: The term advanced therapies refers specifically to ATMPs, although that term is rather nonspecific outside those contexts. Gene-based and cellular biologics, for example, often are at the forefront of biomedicine and biomedical research , and may be used to treat a variety of medical conditions for which no other treatments are available. Building on the market approvals and sales of recombinant virus-based biopharmaceuticals for veterinary and human medicine,

12875-466: The treatment of cytomegalovirus (CMV) retinitis in patients with AIDS . In January 1997, Donald Rumsfeld was appointed chairman, but left the board in January 2001 when he was appointed United States Secretary of Defense during George W. Bush 's first term as president. In March 1999, Gilead acquired NeXstar Pharmaceuticals of Boulder, Colorado . At the time, NeXstar's annual sales of $ 130 million

13000-418: The treatment of migraines . Topical aspirin may be effective for treating some types of neuropathic pain . Aspirin, either by itself or in a combined formulation, effectively treats certain types of a headache , but its efficacy may be questionable for others. Secondary headaches, meaning those caused by another disorder or trauma, should be promptly treated by a medical provider. Among primary headaches,

13125-541: The treatment of otherwise untreatable cancer during the remainder of life. The cost of treatment with a typical monoclonal antibody therapy for relatively common indications is generally in the range of €7,000–14,000 per patient per year. Older patients who receive biologic therapy for diseases such as rheumatoid arthritis , psoriatic arthritis , or ankylosing spondylitis are at increased risk for life-threatening infection, adverse cardiovascular events, and malignancy . The first such substance approved for therapeutic use

13250-481: The treatment of patients with cystic fibrosis who are infected with Pseudomonas aeruginosa . In July 2006, the U.S. Food and Drug Administration (FDA) approved Atripla , a once a day single tablet regimen for HIV, combining Sustiva ( efavirenz ), a Bristol-Myers Squibb product, and Truvada ( emtricitabine and tenofovir disoproxil ), a Gilead product. Gilead purchased Raylo Chemicals, Inc. in November 2006, for

13375-546: The use of engineered plant viruses has been proposed to enhance crop performance and promote sustainable production. In some jurisdictions, biologics are regulated via different pathways from other small molecule drugs and medical devices . Some of the oldest forms of biologics are extracted from the bodies of animals, and other humans especially. Important biologics include: Some biologics that were previously extracted from animals, such as insulin, are now more commonly produced by recombinant DNA . Biologics can refer to

13500-475: The year's final quarter would be $ 53 million, and Barron's noted the FDA approval and subsequent strong sales of the "potentially revolutionary" drug as a positive indicator for the stock. On July 11, 2014, the United States Senate Committee on Finance investigated Sovaldi's high price ($ 1,000 per pill; $ 84,000 for the full 12-week regimen). Senators questioned the extent to which the market

13625-474: Was emtricitabine that was near FDA approval, and it had two other antivirals in its pipeline. The company also announced its first full year of profitability. Later that year, Hepsera ( adefovir ) was approved for the treatment of chronic hepatitis B , and Emtriva ( emtricitabine ) for the treatment of HIV. During this era, Gilead completed its gradual evolution from a biotech startup into a pharmaceutical company. The San Francisco Chronicle noted that by 2003,

13750-442: Was Bayer's brand name; however, its rights to the trademark were lost or sold in many countries . The name is ultimately a blend of the prefix a (cetyl) + spir Spiraea , the meadowsweet plant genus from which the acetylsalicylic acid was originally derived at Bayer + -in , the common chemical suffix. Aspirin decomposes rapidly in solutions of ammonium acetate or the acetates , carbonates , citrates , or hydroxides of

13875-592: Was already approved for treating HIV). The pill was a preventive measure ( PrEP ) for people at high risk of getting HIV through sexual activity. In 2013, the company acquired YM Biosciences , Inc. for $ 510 million. The acquisition brings drug candidate CYT387 , an orally-administered, once-daily, selective inhibitor of the Janus kinase (JAK) family, specifically JAK1 and JAK2, into Gilead's oncology pipeline. The JAK enzymes have been implicated in myeloproliferative diseases, inflammatory disorders, and certain cancers. In 2015,

14000-595: Was biosynthetic "human" insulin made via recombinant DNA . Sometimes referred to as rHI, under the trade name Humulin , was developed by Genentech , but licensed to Eli Lilly and Company , who manufactured and marketed it starting in 1982. Major kinds of biopharmaceuticals include: Research and development investment in new medicines by the biopharmaceutical industry stood at $ 65.2 billion in 2008. A few examples of biologics made with recombinant DNA technology include: Many vaccines are grown in tissue cultures. Viral gene therapy involves artificially manipulating

14125-602: Was contraindicated. Medicines made from willow and other salicylate -rich plants appear in clay tablets from ancient Sumer as well as the Ebers Papyrus from ancient Egypt. Hippocrates referred to the use of salicylic tea to reduce fevers around 400 BC, and willow bark preparations were part of the pharmacopoeia of Western medicine in classical antiquity and the Middle Ages . Willow bark extract became recognized for its specific effects on fever, pain, and inflammation in

14250-426: Was founded in 1987 under the name Oligogen by Michael L. Riordan. The original name was a reference to oligonucleotides , small strands of DNA used to target genetic sequences. Gilead held its initial public offering in 1992, and successfully developed drugs like Tamiflu and Vistide that decade. In the 2000s, Gilead received approval for drugs including Viread and Hepsera , among others. It began evolving from

14375-484: Was given August 2006. In the European Union , a biological medicinal product is one of the active substance(s) produced from or extracted from a biological (living) system, and requires, in addition to physicochemical testing, biological testing for full characterisation. The characterisation of a biological medicinal product is a combination of testing the active substance and the final medicinal product together with

14500-544: Was operating "efficiently and rationally", and committee chairman Ron Wyden ( D - Oregon ) and ranking minority member Chuck Grassley ( R - Iowa ) wrote to CEO John C. Martin asking Gilead to justify the price for this drug. The committee hearings did not result in new law, but in 2014 and 2015, due to negotiated and mandated discounts, Sovaldi was sold well below the list price. For poorer countries, Gilead licensed multiple companies to produce generic versions of Sovaldi; in India,

14625-417: Was reported in 2005, found after attempted co-crystallization of aspirin and levetiracetam from hot acetonitrile . In form I, pairs of aspirin molecules form centrosymmetric dimers through the acetyl groups with the (acidic) methyl proton to carbonyl hydrogen bonds . In form II, each aspirin molecule forms the same hydrogen bonds, but with two neighbouring molecules instead of one. With respect to

14750-502: Was selling it globally. Aspirin is available without medical prescription as a proprietary or generic medication in most jurisdictions. It is one of the most widely used medications globally, with an estimated 40,000 tonnes (44,000 tons) (50 to 120 billion pills ) consumed each year, and is on the World Health Organization's List of Essential Medicines . In 2022, it was the 36th most commonly prescribed medication in

14875-768: Was that with only 350 employees, Gilead still did not yet have the capability to sell its drugs directly to overseas buyers. To avoid having to license future drugs in order to access international markets, Gilead simply acquired the 480-employee NeXstar, which had already built its own sales force in Europe to market AmBisome there. Viread ( tenofovir ) achieved first approval in 2001 for the treatment of HIV. In 2002, Gilead changed its corporate strategy to focus exclusively on antivirals, and sold its cancer assets to OSI Pharmaceuticals for $ 200 million. In December 2002, Gilead and Triangle Pharmaceuticals announced that Gilead would acquire Triangle for around $ 464 million; Triangle's lead drug

15000-409: Was the first to produce acetylsalicylic acid in a pure, stable form. By 1899, Bayer had dubbed this drug Aspirin and was selling it globally. The word Aspirin was Bayer's brand name, rather than the generic name of the drug; however, Bayer's rights to the trademark were lost or sold in many countries. Aspirin's popularity grew over the first half of the 20th century leading to fierce competition with

15125-426: Was therefore inspired to name his company Gilead. After founding Oligogen, he contacted the nonprofit about the naming issue and secured the right to use the Gilead Sciences name in exchange for a $ 1,000 donation. By 1988, the company had moved its headquarters to Foster City's Vintage Park neighborhood, where it has been based ever since. The company began to develop small molecule antiviral therapeutics in 1991, when

15250-473: Was three times Gilead's sales; it sold AmBisome, an injectable fungal treatment, and DaunoXome , an oncology drug taken by HIV patients. That same year, Roche announced FDA approval of Tamiflu ( oseltamivir ) for the treatment of influenza . Tamiflu was originally discovered by Gilead and licensed to Roche for late-phase development and marketing. One reason for entering into the Tamiflu licensing agreement

15375-463: Was touch and go for a long time". Finding a way for Gilead to make money was Riordan's top priority "every second of the day for eight years". Gilead's antisense intellectual property portfolio was sold to Ionis Pharmaceuticals . Gilead debuted on the NASDAQ in January 1992. Its initial public offering raised $ 86.25 million in proceeds. In June 1996, Gilead launched Vistide ( cidofovir injection) for

15500-406: Was unsuccessful. The company focused its early research on making small strands of DNA ( oligomers , or more particularly, oligonucleotides ) to target specific genetic code sequences – that is, antisense therapy , a form of gene therapy . According to Riordan, he had always wanted to use the name Gilead Sciences all along. Still, he used Oligogen as a temporary name because he needed to deal with

15625-526: Was valued at US$ 93.4 billion in October 2018. As of 2017, Gilead's challenge is to develop or acquire new blockbuster drugs before its current revenue-producers wane or their patent protection expires. Gilead benefited from the expansion of Medicaid in the ACA; Leerink analyst Geoffrey Porges wrote that Gilead's HIV drugs could face funding pressure under reform proposals. Gilead has $ 32 billion in cash, but $ 27.4 billion

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