Gilead Sciences Patient Finder Analysis

Executive Summary

This analysis evaluates Gilead Sciences' drug portfolio for suitability with Ada Patient Finder, a symptom-assessment platform designed to surface undiagnosed patients. Analysis focused on drugs where diagnostic delay exceeds 6 months, per-patient revenue exceeds $50K/year, and underdiagnosis rate exceeds 20%.

            Key Finding: Livdelzi (primary biliary cholangitis) represents the highest-value 
            opportunity with 4,200–7,800 undiagnosed eligible patients in the USA, clear symptom-based detection 
            feasibility, and $2.1M–4.2M annual Ada revenue potential at 5–10% Patient Finder penetration.
        

Portfolio Opportunity Summary

Drug	Tier	Fit Score	Addressable Undiagnosed (USA)	Ada Revenue Opportunity (5% Penetration, USA)	Key Barrier
Livdelzi Primary Biliary Cholangitis	TIER 1	8/10	4,200–7,800	$2,100,000	None (symptom-based detection feasible)
Vemlidy Chronic Hepatitis B	TIER 2	7/10	720,000–810,000	$112,200* * @ 2% risk screening	Requires risk-based screening feature (not symptom-driven)
Trodelvy Metastatic TNBC	TIER 2	6/10	2,000–5,000 (early-stage screening)	$8,750,000 Screening fee model	Long latency (2–5 years to Trodelvy); screening fee model not revenue share
Biktarvy HIV-1 Treatment	TIER 3	4/10	~158,000 (total undiagnosed HIV)	<$500,000	Screening programs more effective; low diagnostic delay
Descovy HIV PrEP	TIER 3	5/10	~800,000–900,000 (PrEP gap)	<$400,000	Preventive, not diagnostic; behavioral risk required
Yescarta CAR-T for Lymphoma	NO	3/10	Minimal	N/A	Tertiary therapy; rapid DLBCL diagnosis
Veklury COVID-19	NO	2/10	Minimal	N/A	Widespread testing; no diagnostic gap

Livdelzi (Seladelpar) — Primary Biliary Cholangitis TIER 1: HIGH PRIORITY

Fit Score

8/10

USA Addressable

4.2K–7.8K

Net Revenue/Patient

$100K/yr

Ada Revenue (5% PF)

$2.1M/yr

Market Overview

Market	PBC Prevalence	Undiagnosed PBC	Livdelzi-Addressable	Net Revenue/Patient
USA	106,340	21,268–31,902	4,200–7,800	$100,000/yr
DACH	30,895	7,724	1,500–2,500	$112,000/yr
Rest of World (Europe)	89,000	22,250	4,000–7,000	$112,000/yr
TOTAL	226,235	51,242–61,876	9,700–17,300	—

Key Strengths

High diagnostic delay (median 1–3 years from symptom onset to diagnosis)
Specific symptom combination: persistent pruritus + debilitating fatigue in women 40–60 years
20–30% underdiagnosis rate (asymptomatic early disease detected incidentally)
Strong symptom-based detection feasibility (Ada can flag pruritus + fatigue → prompt ALP/AMA testing)
High per-patient revenue ($100K/year USA, $112K/year Europe)
Clear Gilead motivation: "tracking above expectations" in Q4 2025 earnings; "significant unmet need" positioning
First-in-class PPARδ agonist with dual mechanism (liver inflammation + pruritus relief)

Barriers: None (symptom-based detection feasible with current Ada platform)

Recommendation: LAUNCH Patient Finder pilot Q2 2026 (USA); expand to Europe Q4 2026. Negotiate 8–12% of first-year net revenue per Ada-surfaced patient. Target: Surface 400–800 undiagnosed Livdelzi-eligible patients in Year 1, yielding $2.4–6.4M Ada revenue.

Ada Revenue Opportunity

Market	1% PF Penetration	5% PF Penetration	10% PF Penetration
USA	$420,000	$2,100,000	$4,200,000
DACH	$141,120	$705,600	$1,411,200
Rest of World	$383,040	$1,945,440	$3,890,880
GLOBAL TOTAL	$944,160	$4,751,040	$9,502,080

Vemlidy (Tenofovir Alafenamide) — Chronic Hepatitis B TIER 2: MODERATE (CONDITIONAL)

Fit Score

7/10

USA Addressable

720K–810K

Net Revenue/Patient

$10–12K/yr

Ada Revenue (2% Risk Screening)

$112K/yr

Market Overview

Market	Chronic HBV Prevalence	Undiagnosed (75%)	Treatment-Eligible Undiagnosed	Net Revenue/Patient
USA	2,400,000	1,800,000	720,000–810,000	$10,000–12,000/yr
DACH	830,200	606,046	272,721	$8,000–10,000/yr
Rest of World	5,000,000	3,750,000	1,687,500	$9,000/yr

Key Strengths

Massive addressable market: 720K–810K undiagnosed treatment-eligible patients (USA alone)
75% underdiagnosis rate (CDC 2023 data)
CDC universal adult HBV screening recommendation (2023) creates external tailwind
Gilead HBV functional cure trials (selgantolimod + VIR-2218) signal long-term strategic interest

Barriers: Chronic HBV is asymptomatic until late-stage cirrhosis/HCC. Requires risk-based screening feature (birthplace, PWID, family history, healthcare worker status) — NOT symptom-driven detection. Ada must build new product capability (6–12 month development timeline).

Recommendation: CONDITIONAL. Develop risk-based screening module; pilot 2027. Negotiate 2–5% of first-year net revenue (lower % due to risk-based vs. symptom-based). Contingent on Ada product roadmap prioritization and Gilead co-investment in risk assessment algorithm development.

Ada Revenue Opportunity (Risk-Based Screening Model)

Market	0.5% At-Risk Prompted	2% At-Risk Prompted	5% At-Risk Prompted
USA	$28,050	$112,200	$280,500
DACH	$9,450	$36,450	$91,125
Rest of World	$45,900	$182,250	$455,625
GLOBAL TOTAL	$83,400	$330,900	$827,250

            Note: Revenue is significantly lower than Livdelzi due to: (1) lower per-patient revenue 
            ($10–12K vs. $100K), (2) lower Patient Finder fee (2–3% vs. 8–10%), and (3) risk-based vs. symptom-based 
            detection. Opportunity is large in absolute patient numbers but requires new Ada product capability.
        

Trodelvy (Sacituzumab Govitecan) — Metastatic TNBC TIER 2: SCREENING NAVIGATION (CSR MODEL)

Fit Score

6/10

Underscreened Early TNBC

2K–5K/yr

Net Revenue/Patient

$200–250K/yr

Ada Revenue (5% Screening)

$8.75M/yr

Market Overview (Early-Stage TNBC Screening Opportunity)

Market	TNBC Incidence	Underscreened Cases	Eventual Trodelvy-Eligible (35% Recurrence, 2–5 Yrs)
USA	54,000/year	2,000–5,000 (Black women 25–40, uninsured)	~1,225/year (long latency)
DACH	12,075/year	500–1,000	~350/year
Rest of World	37,500/year	1,500–3,000	~1,000/year

Key Strengths

Ada can assess breast lump symptoms and risk factors (family history, BRCA1/2, race, age)
High-risk populations (Black women 25–40) have lower mammography screening rates and present at later stages
Trodelvy is Gilead's strategic priority: $1.4B revenue (2025), peak $3–4B (2027–2029)
Potential CSR (corporate social responsibility) partnership aligned with diversity/equity initiatives

Barriers: Long latency (2–5 years) between Ada-detected early-stage TNBC and Trodelvy use complicates revenue attribution. Most metastatic TNBC patients are already diagnosed with breast cancer; metastases detected via routine surveillance imaging. Gilead's growth strategy is label expansion (first-line, NSCLC) and market share gains, NOT patient finding.

Recommendation: CSR PARTNERSHIP on breast health screening navigation (not Trodelvy-specific). Position as diversity/equity initiative (Black women's health). Use screening navigation fee model (flat $500/mammography referral), NOT Trodelvy revenue share. Potential co-branding with American Cancer Society or Susan G. Komen.

Ada Revenue Opportunity (Screening Navigation Fee Model)

Market	1% Underscreened Prompted	5% Underscreened Prompted
USA	$1,750,000 ($500 × 3,500 referrals)	$8,750,000 ($500 × 17,500 referrals)
DACH	$250,000	$1,250,000
Rest of World	$750,000	$3,750,000
GLOBAL TOTAL	$2,750,000	$13,750,000

Strategic Recommendations

HIGH PRIORITY (Tier 1)

1. Livdelzi (PBC) Patient Finder Pilot — Launch Q2 2026
Build pruritus + fatigue assessment algorithm for women >40. Partner with Gilead to refine symptom severity thresholds. Navigate users to hepatology/GI with prompt for liver function tests (ALP, GGT, AMA). Target: Surface 400–800 undiagnosed Livdelzi-eligible patients in Year 1. Revenue share: 8–12% of first-year net revenue per Ada-surfaced patient. Ada revenue: $2.4–6.4M (USA).

MODERATE PRIORITY (Tier 2, CONDITIONAL)

2. Vemlidy (HBV) Risk-Based Screening Pilot — Pilot 2027 (Requires Product Development)
Develop epidemiologic risk assessment module (birthplace, PWID, family history, healthcare worker). Integrate into Ada's annual health check-up or primary care navigation flows. Target: Prompt 10,000–20,000 at-risk individuals to HBV screening (HBsAg). Revenue share: 2–5% of first-year net revenue. Ada revenue: $60–300K (USA). Contingent on Ada product roadmap prioritization and Gilead co-investment.

MODERATE PRIORITY (Tier 2, CSR MODEL)

3. Trodelvy Screening Navigation — CSR Partnership (Black Women's Health Equity)
Build breast cancer risk assessment (family history, BRCA1/2, race, age). Navigate high-risk women to mammography and genetic counseling. NOT Trodelvy-specific (general breast health). Revenue model: Flat screening navigation fee ($500/mammography referral). Ada revenue: $10–25M/year (USA @ 20K–50K referrals). Position as Gilead CSR initiative with potential co-branding.

LOW/NO PRIORITY (Tier 3)

4. Biktarvy, Descovy, Yescarta, Veklury
No Patient Finder focus. Screening programs more effective (HIV); tertiary therapy (CAR-T); no diagnostic gap (COVID-19). Niche opportunistic integration for Descovy (PrEP navigation) only.

Metric	Year 1 (USA Only)	Scalability (10M MAU, 5% Penetration, Global)
Livdelzi (PBC)	$2.4–6.4M	$30–60M annually
Vemlidy (HBV)	$60–300K (conditional)	$5–15M annually (if risk-based screening built)
Trodelvy (TNBC)	$10–25M (screening fee model)	$5–20M annually
TOTAL ADA REVENUE POTENTIAL	$3.1–7.6M (Livdelzi-driven)	$40–95M annually (mature penetration, global)

Gilead Sciences

Executive Summary

Portfolio Opportunity Summary

Livdelzi (Seladelpar) — Primary Biliary Cholangitis TIER 1: HIGH PRIORITY

Market Overview

Key Strengths

Ada Revenue Opportunity

Vemlidy (Tenofovir Alafenamide) — Chronic Hepatitis B TIER 2: MODERATE (CONDITIONAL)

Market Overview

Key Strengths

Ada Revenue Opportunity (Risk-Based Screening Model)

Trodelvy (Sacituzumab Govitecan) — Metastatic TNBC TIER 2: SCREENING NAVIGATION (CSR MODEL)

Market Overview (Early-Stage TNBC Screening Opportunity)

Key Strengths

Ada Revenue Opportunity (Screening Navigation Fee Model)

Strategic Recommendations

HIGH PRIORITY (Tier 1)

MODERATE PRIORITY (Tier 2, CONDITIONAL)

MODERATE PRIORITY (Tier 2, CSR MODEL)

LOW/NO PRIORITY (Tier 3)

Overall Opportunity Summary