At first glance, Gilead Sciences, Inc. (NASDAQ:GILD) and Intuitive Surgical, Inc. (NASDAQ:ISRG) don’t make for the most obvious comparison. One sells medicines led by a massive HIV franchise, while the other has built its business around robotic surgery. Yet both have given investors a similar reason to pay attention this year, which is that growth has been stronger than many mature healthcare businesses typically deliver.
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Gilead’s product sales excluding Veklury grew 10% in its latest quarter, enough for management to raise its full-year sales outlook. Intuitive Surgical went further, growing revenue 19% as da Vinci procedure volumes rose another 15%.
Let’s take a deeper look at the two companies and what investors should keep in mind when considering them.
Bull Case
Gilead’s latest quarter had more going for it than another strong performance from Biktarvy. HIV sales rose 12% to $5.7 billion, with Biktarvy growing 7% to $3.8 billion. Descovy was much faster, jumping 48% to $967 million, while Yeztugo generated $232 million compared with just $15 million a year earlier. The more interesting part of the quarter, however, may have been what happened outside HIV. Liver-disease sales increased 10% to $877 million, helped by Livdelzi, where revenue climbed from $78 million to $167 million. Trodelvy added another $457 million, up 26%.
Gilead Sciences, Inc. doesn’t particularly need another reminder that its HIV franchise is strong; what it needs is evidence that other parts of the portfolio can become large enough to matter alongside it. Management also raised its expectations for the year, and the company now expects 2026 product sales of $30.1 billion to $30.4 billion, with product sales excluding Veklury reaching $29.8 billion to $30.1 billion.
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Intuitive Surgical, Inc. is working from a different playbook, where every additional da Vinci system placed in a hospital doesn’t just generate the initial system revenue but rather expands the installed base on which future procedures can be performed, supporting demand for instruments, accessories and services. The company’s fiscal Q2 offered a good illustration of that model at work for investors, as revenue increased 19% to $2.89 billion, while worldwide da Vinci procedures grew approximately 15%. Instruments and accessories revenue followed procedure volumes higher, increasing 18% to $1.73 billion. Non-GAAP EPS reached $2.80, compared with $2.19 a year earlier.
Furthermore, Intuitive placed 468 da Vinci systems during the quarter, up from 395 a year earlier. Of those, 246 were da Vinci 5 systems, compared with 180 in Q2 2025, which brought the worldwide da Vinci installed base to 11,710 systems, reflecting an increase of 12%. There is a compounding quality to those numbers, as more systems can support more procedures, and more procedures create additional demand for the instruments and accessories used with them. That is what makes Intuitive’s growth model particularly difficult to replicate.
Bear Case
For Gilead, the uncomfortable number isn’t buried very far down the income statement but is, surprisingly, its HIV segment that generated $5.69 billion of $7.63 billion in quarterly product sales. Strip away everything else and roughly three out of every four dollars of product revenue still trace back to one therapeutic area.
Gilead has spent heavily trying to change that equation, and recorded $11.2 billion of acquired in-process R&D expenses in fiscal Q2, which was primarily associated with Arcellx, Tubulis, and Ouro Medicines. Those transactions contributed to quarterly GAAP and non-GAAP losses per share of $8.45 and $6.75, respectively. Nor is every diversification effort moving forward at the same speed, as Trodelvy grew 26%, but Cell Therapy sales declined 14% to $417 million amid competitive headwinds. Yescarta fell 12%, while Tecartus declined 24%.
Intuitive’s concern, on the other hand, shows up in the growth rate investors can reasonably expect from here. Worldwide da Vinci procedures grew approximately 15% in fiscal Q2, compared with 17% a year earlier. Management continues to expect 13.5% to 15.5% procedure growth for 2026 and has said it expects the result to land closer to the midpoint of that range.
Margins also face some pressure from tariffs, as the company expects its 2026 non-GAAP gross margin to fall between 68% and 69%, with its assumptions incorporating an estimated one-percentage-point tariff impact. Management has cautioned that additional tariffs beyond those assumptions could materially affect its 2026 results. While none of that points to a weak business, it does, however, mean that Intuitive Surgical, Inc. needs to keep producing substantial growth while navigating costs that aren’t entirely within its control.
Conclusion
There is an interesting inversion between these two companies. Gilead needs more diversification, but the business it depends on most is currently performing exceptionally well. HIV sales grew 12%, newer products are contributing, and management raised its full-year sales outlook. The question is how much of that momentum can eventually come from outside HIV.
Intuitive already has a business model capable of producing growth from several directions, which include new system placements, a larger installed base, rising procedures, and the instruments and accessories those procedures consume. The question is how long those engines can continue to drive mid-teens procedure growth as the business grows.
So the risk-adjusted case isn’t simply about choosing the company with the higher growth rate. Gilead asks investors to accept concentration in exchange for a franchise that is currently growing strongly, and Intuitive asks them to count on an already successful growth machine continuing to deliver at a high level. Both arguments have evidence behind them, and what separates the stocks is where investors would rather take the risk: Gilead’s portfolio concentration or Intuitive’s increasingly demanding growth expectations.
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This article is originally published at Insider Monkey.
