Gilead and GSK are showing different moves in the HIV treatment market.

Gilead, which maintains the balance of three-drug therapy, is concentrated on the most recently released Biktarvy, while GSK has a slow generational shift with various alternatives such as two-drug regimens and long-acting injections.

According to the third-quarter report of global big pharma, the sales of Gilead’s HIV drugs, excluding Biktarvy, declined en masse.

In particular, Truvada’s third-quarter sales, which dominated the HIV drugs market before TAF-based regimens were released, plunged nearly 90% year-on-year to less than $100 million. Truvada-based combination therapy had previously been reduced to less than $100 million.

TAF-based combination drugs have all dropped in sales except for Biktarvy. Descovy and Genvoya’s third-quarter sales fell more than 10% year-on-year, while Odefsey also declined nearly 10%.

On the other hand, Biktarvy grew more than 20% in the third-quarter, surpassing the $2.2 billion mark for the first time since its launch. The cumulative sales for nine months also rose to an average of $2 billion per quarter to $6.1 billion.

Other TAF-based combinations such as Descovy, Genvoya, and Odefsey, whose sales have decreased compared to the same period last year, also posted more than $10 billion along with Biktarvy, with cumulative sales exceeding $1 billion over nine months.

GSK, which is leading the paradigm shift in HIV treatment, such as two-drug regimens (Juluca, Dovato), multidrug-resistant HIV (Rukobia), and long-acting injections (Cabenuva), has yet to overcome the dominance of existing products with its new drugs.

Triumeq achieved sales of about $700 million and Tivicay $500 million in the third-quarter, while Dovato was about $300 million and Juluca $200 million, less than half of Triumeq.

However, unlike Juluca, stranded in the $1.8 billion mark, Dovato is chasing the leading group with a triple-digit growth rate.

Rukobia, released last year, and Cabenuva at the beginning of the year, recorded $17 million in sales in the third-quarter, but growth is still slow.

Amid the confrontation between the two companies, Johnson & Johnson’s sales of Edurant and Prezista are stagnant at around $250 million and $500 million.

MSD’s Isentress, which had been rising and falling to the $200 million mark, shrank to less than $100 million in the third-quarter.

In the meantime, in the hepatitis C treatment market, where the market size has decreased significantly, Gilead’s Epclusa and AbbVie’s Mavyret remain in existence.

Epclusa and Mavyret remained at a year-on-year level in the third-quarter with sales of $300 million and $430 million.

Harvoni’s quarterly sales amounted to $43 million, down nearly 50% year-on-year, and other hepatitis C treatments are no longer counted.

While the hepatitis B treatment market has changed its lead to Gilead’s Vemlidy, which surpassed $200 million for the second consecutive quarter, BMS’s Baraclude is struggling to maintain its quarterly sales of $100 million.

On the other hand, Viread’s third-quarter sales fell to $26 million. In KRW, it is worth about KRW 30 billion, which is only 1.5 times the domestic sales of Viread reported by Yuhan Corporation.

In Korea, Viread’s market size is still more than double that of Vemlidy (about KRW 9.5 billion in the third-quarter, according to Yuhan’s report) due to restrictions on reimbursement.