PETRI DISH PERSPECTIVES: BIOTECH UNLEASHED

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PETRI DISH PERSPECTIVES: BIOTECH UNLEASHED

Episode 18: Gilead

August 28, 2025 • Manead Khin • Season 1 • Episode 18

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In this episode of Petri Dish Perspectives: Biotech Unleashed, we dive into the remarkable and controversial story of Gilead Sciences, a company that redefined what medicine could achieve. From its beginnings in the late 1980s under physician-scientist Michael Riordan, Gilead transformed antiviral drug development with breakthroughs in HIV treatment, revolutionized global health with a cure for hepatitis C, and pushed into oncology with cutting-edge CAR-T therapies.

But alongside these triumphs came firestorms of criticism, from the $84,000 price tag of Sovaldi to debates around HIV drug access and patents. Gilead has long walked the fine line between lifesaving innovation and public outrage, forcing society to wrestle with the question: What is the true price of a cure?

Join us as we unpack Gilead’s origins, its blockbuster breakthroughs, its controversies, and what lies ahead for one of biotech’s most influential and polarizing companies.

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Hello and welcome to Petri Dish Perspectives: Biotech Unleashed, the podcast where we geek out about science and the companies shaping the future of healthcare. I’m your host, Manead, and I’m a PhD scientist by training, biotech storyteller by choice. With every new episode released on Thursday, my goal is to deliver digestible pieces of information on healthcare companies under 30 mins.

Today we’re diving into Gilead Sciences. You may have been seeing Gilead in the news a lot more recently since Kite, which is a Gilead company, acquired Interius BioTherapeutics, on August 21, 2025. This acquisition aims to advance Kite's expertise in cell therapy by incorporating Interius's in vivo platform, which delivers DNA directly into the patient's cells to generate CAR T-cells within the body.

Founded in 1987 in Foster City, California, Gilead grew from a scrappy startup with a bold idea — turning chemistry into antiviral breakthroughs — into one of the world’s largest and most influential biopharma players, with a market cap that has soared past $100 billion.

But the company’s journey is not without controversy: debates over drug pricing, government partnerships, and the ethics of access have followed Gilead every step of the way.

Quick disclaimer: full credit goes to all original sources cited in the transcript.

Grab your coffee or tea, settle in, and let’s jump right in.

Segment 1: Founding Story

Our story begins in 1987, in the middle of one of the darkest chapters in modern medicine: the HIV/AIDS epidemic. At the time, the disease was cutting through communities with brutal speed, particularly in San Francisco and New York. Entire networks of young men were being wiped out, with doctors and researchers scrambling for answers, but only able to offer a handful of experimental drugs that barely slowed the inevitable.

One of the physicians watching this unfold was Michael L. Riordan, a Harvard-trained doctor in his early thirties. Riordan’s journey had already taken him through some of the world’s most prestigious institutions — Johns Hopkins for his medical training, the University of Oxford as a Rhodes Scholar, and the University of California, San Francisco, where he practiced medicine. But what set him apart was his vision: he believed the key to the next generation of treatments wouldn’t come just from traditional biology, but from nucleic acid chemistry.

Riordan became convinced that if scientists could design molecules that disrupted viruses at the genetic level, they could stop diseases like HIV in their tracks. It was a radical idea at the time, one that straddled chemistry, virology, and medicine. To pursue it, Riordan took a leap. With venture capital backing, he founded a company in Foster City, California, originally called Oligogen, but soon renamed Gilead Sciences. Gilead Sciences changed its name from Oligogen due to a trademark conflict, the founder's long-held desire for the name, and a desire for a name that better represented the company's broader healing mission.

From the beginning, Riordan sought out some of the brightest chemists and virologists in the world. This wasn’t going to be just another biotech startup chasing incremental discoveries. Gilead was built on a clear mission: turn cutting-edge nucleotide chemistry into life-saving antiviral drugs.

By the early 1990s, the company had gone public — an early vote of confidence that gave Gilead access to capital, talent, and the ability to take on risky, high-stakes projects. IPO listing price was $20.16. Little did anyone know, this scrappy Bay Area biotech would grow into one of the most influential pharmaceutical companies of its era.

Segment 2: Early Discoveries and Breakthrough Science

In its earliest days, Gilead zeroed in on oligonucleotides — short strands of DNA or RNA designed to interfere with viral replication. It was a revolutionary concept, essentially trying to fight viruses by using the language of their own genetic code. But the science proved extraordinarily challenging. The molecules were unstable, delivery into cells was difficult, and the technology simply wasn’t ready for prime time.

Recognizing this, Gilead pivoted — a move that would define its ability to adapt again and again throughout its history. Instead of pushing oligonucleotides too far ahead of the science, the company turned to antiviral small molecules that mimicked nucleotides and blocked viruses from replicating their genetic material. This pivot may seem subtle, but it marked the beginning of a string of breakthroughs.

In 1996, Gilead scored its first FDA approval with Vistide (cidofovir), a treatment for cytomegalovirus (CMV) infections in AIDS patients. CMV wasn’t the biggest market, but for those suffering from late-stage AIDS complications, it was a lifeline. More importantly, it validated Gilead’s scientific approach and showed investors that the company could translate chemistry into real medicine.

But the real breakthrough came from another discovery brewing in Gilead’s labs: tenofovir. First developed in the mid-1990s, tenofovir was a nucleotide reverse transcriptase inhibitor (NRTI), designed to block HIV from making copies of itself. What seemed at first like just another antiviral would, over the next two decades, become the backbone of HIV therapy worldwide. As of the end of 2014, it is estimated that over 7.5 million person-years of tenofovir have been prescribed globally.

These early discoveries laid the foundation for Gilead’s identity: a company that wasn’t just riding the wave of the biotech boom, but shaping the very future of antiviral medicine.

Segment 3: The Blockbusters That Defined Eras

1. HIV Treatments
By the early 2000s, HIV therapy was improving, but it was still grueling — patients took handfuls of pills every day, often with harsh side effects. Then, in 2001, Gilead’s Viread (tenofovir disoproxil fumarate) was approved. For the first time, patients had a potent, once-daily pill to keep HIV in check.

But Gilead didn’t stop there. It began combining tenofovir with other antivirals into single, fixed-dose pills. The results were revolutionary: Truvada, and later Atripla. One pill, once a day. It was more than convenience — it transformed adherence, outcomes, and life expectancy.

These drugs redefined HIV treatment, turning it from a death sentence into a manageable chronic condition. Later, Truvada would break even more ground, becoming the first drug approved for PrEP (pre-exposure prophylaxis) — a way for HIV-negative individuals to prevent infection altogether. It was a milestone not just in medicine, but in public health.

2. The Hepatitis C Revolution
If HIV made Gilead, hepatitis C catapulted it to the top of the pharmaceutical world.

In 2011, Gilead stunned Wall Street by acquiring a small company called Pharmasset for $11 billion. Critics howled that it was wildly overpriced. But Pharmasset had an experimental drug in its pipeline: sofosbuvir.

Two years later, that bet paid off spectacularly. Gilead launched Sovaldi, and soon after, the combo drug Harvoni. For the first time in history, hepatitis C — a chronic viral infection that caused liver failure, cirrhosis, and cancer — could be cured with a simple pill. (Hepatitis C is caused by the hepatitis C virus (HCV), which is a bloodborne virus that primarily infects the liver, potentially leading to inflammation and serious liver disease such as cirrhosis or liver cancer. The virus is transmitted when infected blood enters another person's body, most commonly through sharing needles, but it can also occur from other exposures like using unsterilized tattoo equipment or from a mother to her baby during birth.)

Cured. Not just managed. Cured.

It was hailed as one of the greatest medical breakthroughs of the 21st century. Yet, it wasn’t without controversy. The $84,000 price tag for a 12-week course of Sovaldi ignited fierce debates about drug pricing, access, and the ethics of profit in medicine. The shadow of that pricing debate still hangs over Gilead today, but the science itself remains undeniable: a once-incurable disease could now be eradicated.

3. Beyond Viruses: Cell Therapy
Just when it seemed Gilead’s legacy would be forever tied to antiviral pills, the company made a bold pivot. In 2017, it acquired Kite Pharma for $11.9 billion, leaping into the cutting-edge world of cell therapy.

Kite had pioneered CAR-T therapy, which involves taking a patient’s own immune cells, genetically reprogramming them, and infusing them back to attack cancer. Kite’s flagship therapy, Yescarta, became one of the first CAR-T treatments approved for lymphoma, a cancer of the lymphatic system.

CAR T-cell therapy (Chimeric Antigen Receptor T-cell therapy) is a personalized form of cancer treatment where a patient's T-cells (a type of immune cell) are genetically modified in a lab to express a specific chimeric antigen receptor (CAR). These engineered CAR T-cells are then infused back into the patient to target and kill cancer cells that have specific proteins (antigens) on their surface, effectively using the body's own immune system to fight the disease.

Unlike small-molecule drugs, CAR-Ts are living medicines — complex, personalized, and logistically challenging. For Gilead, it marked not only entry into oncology but also a willingness to embrace a radically new paradigm. While still a smaller part of Gilead’s portfolio compared to antivirals, CAR-Ts signaled that the company was looking beyond viruses, aiming to make its mark in cancer.

Segment 4: Controversies and Criticism

For all its scientific breakthroughs, Gilead has often found itself at the center of controversy — especially around the cost of its drugs.

The most infamous example came with Sovaldi, the hepatitis C cure launched in 2013. The science was nothing short of miraculous: a simple pill that could eliminate a virus responsible for hundreds of thousands of deaths each year. But the sticker price was jaw-dropping — $84,000 for a 12-week course, or about $1,000 per pill.

Almost overnight, debates erupted in Congress, in the media, and in patient advocacy circles. Was it ethical to charge so much for a cure, even if the company argued it saved healthcare systems money in the long run by preventing liver transplants, cancer, and hospitalizations? The uproar was global. In low- and middle-income countries, the cost put the drug completely out of reach, sparking lawsuits, compulsory licensing battles, and pressure from the World Health Organization. Eventually, Gilead licensed generic manufacturers to produce cheaper versions abroad, but the damage to its public image was lasting.

The pricing controversies weren’t limited to hepatitis C. In HIV, drugs like Truvada for PrEP also came under fire. Activists pointed out that much of the underlying research for Truvada was publicly funded by the U.S. government, yet Gilead reaped billions in profit while access remained limited in many communities most at risk.

Segment 5: People Who Shaped Gilead

While founder Michael Riordan laid the foundation, one figure who truly transformed Gilead into a global powerhouse was John Martin.

Martin, a trained chemist from the University of Chicago, joined Gilead in 1990 and became CEO in 1996. Soft-spoken but relentless, Martin spearheaded the HIV and HCV revolutions.

It was under his leadership that Gilead acquired Pharmasset, launched blockbuster antivirals, and became one of the most profitable biopharmas on earth. Martin believed in simple, once-daily regimens that improved adherence and outcomes — and he pushed Gilead’s scientists and business teams to deliver.

By the time he stepped down in 2016, Gilead was generating over $30 billion in annual revenue. His vision — combining chemistry, business savvy, and patient need — made him one of biotech’s most consequential leaders.

Unfortunately, John passed away in 2021, and it was reported by Forbes that he had a net worth of $1.1B when he passed.

Segment 6: Lessons from Gilead

Gilead’s story offers several lessons:

Bold bets can change medicine. The Pharmasset deal looked crazy — until it cured hepatitis C.
Access and pricing matter. Breakthroughs lose shine if patients can’t afford them.
Leaders shape companies. John Martin’s focus on simplicity and adherence literally redefined HIV care.
Reinvention is constant. From antivirals to oncology, Gilead has had to keep pivoting to stay relevant.

Segment 7: What’s Next for Gilead?

So, what lies ahead?

Oncology Expansion: With Yescarta and Tecartus, Gilead is betting on cell therapy. The challenge: making these complex therapies scalable and affordable.
HIV Cure Research: Beyond treatment and prevention, Gilead is investing in HIV cure strategies, including gene editing and immune therapies.
Emerging Viruses: As COVID-19 showed with remdesivir (Veklury), Gilead remains central in antiviral preparedness.
Pipeline Diversification: The company is pushing into immunology and inflammation — trying to reduce reliance on HIV drugs for revenue.

Gilead’s future may hinge on whether it can once again bet boldly and deliver breakthroughs that reshape medicine. Gilead’s market cap currently stands at a little over $142B and the stock price is at $114 by the time the episode was recorded. Gilead Sciences has a global presence, with their corporate headquarters in Foster City, California, and a significant number of locations throughout the United States (including California, North Carolina, and New Jersey) and Canada, plus a manufacturing site in Cork, Ireland. The company also operates offices and facilities across Europe, Africa, the Middle East, and the Asia-Pacific region, with a global workforce spanning six continents. According to their website, Gilead has over 18,000 employees. According to Glassdoor, a PhD at Gilead salary ranges but could be anywhere from $160K-$212K.

Outro

And that’s Gilead Sciences — a company that has cured diseases, transformed epidemics, and sparked global debates on what innovation is worth.

From Michael Riordan’s vision in 1987 to John Martin’s leadership through the HIV and HCV eras, Gilead shows us how biotech can literally change the world — but also how fragile reputation can be when science collides with economics.

My hope for you, the listener, is this: that when you hear about Gilead in the news — whether it’s another pricing controversy, a new HIV breakthrough, or a bold bet on cancer — you’ll understand the decades of science, leadership, and complexity that brought us here.

Thank you for joining me on this journey through biotech history. If you enjoyed today’s episode, please follow, rate, and share Petri Dish Perspectives: Biotech Unleashed.

Until next time, I’m Manead — reminding you that the Petri dish may be small, but the ideas born in it can change the world.

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