Leadership Lessons from Gilead Sciences CEO Daniel O’Day

The biopharmaceutical industry has been at a pivotal moment—driven by technological breakthroughs, evolving economic models, and an increased focus on global health equity. Yet, significant challenges remain, particularly in speeding up clinical trials and integrating complex data into actionable decisions.

Daniel O’Day ‘97, the Chairman and CEO of Gilead Sciences, spoke with Columbia Business School Dean Costis Maglaras as part of the annual CBS Healthcare Conference, hosted by The Hub. He called on business leaders to invest in cutting-edge technologies, adopt bold new business models, and build global partnerships that would transform patient outcomes and redefine the role of industry in addressing some of the world’s most pressing health challenges.

O’Day’s insights offer a valuable roadmap for the future of biopharma:

AI is Driving Drug Discovery and Precision Medicine

A key pillar of Gilead’s strategy is precision medicine—a field that is rapidly shifting treatment paradigms. He recounted how the integration of cell therapy, exemplified by Gilead’s acquisition of Kite Pharma, has revolutionized care in blood cancers. Once a diagnosis with a mere six-month prognosis, certain blood cancers now see nearly 50% of patients enjoying multi-year survival after a single, targeted intervention.

This leap forward is driven not only by breakthroughs in therapy but also by the innovative use of data and AI. O’Day noted that the application of AI in drug discovery—while still in its early days—is already making a significant impact. Companies are already pioneering efforts to curate and harness electronic medical record data, enabling AI models to predict drug efficacy, optimize clinical trial recruitment, and streamline manufacturing processes.

O’Day cautioned that AI in medicine is not a simple plug-and-play solution, however. Biodata is inherently complex; with each individual harboring approximately 30 trillion cells, data quality can vary widely, so it is essential to invest in rigorous data curation. For business leaders, embracing AI means committing to both technological and human investments—a dual approach that can ultimately reduce drug development timelines and help businesses differentiate themselves from competitors.

Rethink Business in a Curing Economy

O’Day believes that the shift from chronic treatment models to curative therapies has transformed the pharmaceutical industry. In an industry traditionally built on recurring revenue from long-term care, breakthroughs — such as a 12‑week oral cure for Hepatitis C or innovative HIV treatments — had upended conventional business models. Now, when a disease is cured, the patient pool contracts, and so does the traditional revenue streams.

"When you cure Hepatitis C, the good news is, you're successful on the revenue side. The good news also is there are fewer people with Hepatitis C and your revenue comes down again. So you have to be willing to both have continual innovation, but also ride some of those mountains if you're going to be brave enough to end diseases,” O’Day said.

O’Day shared that Gilead had responded to this industry disruption by pioneering value-based reimbursement models that linked payment to patient outcomes rather than treatment volume. The approach demonstrated that economic sustainability could be maintained even as the industry moves toward cures rather than chronic management.

Leaders, O’Day stressed, should adopt a long-term mindset, where return on capital or acquisitions are evaluated on a decade-long timeframe rather than by short-term measures.

The Road Ahead

O’Day envisions a future where AI not only accelerates drug discovery but also could refine surrogate markers in oncology and autoimmune diseases. He believes that by developing more tolerable drug combinations and leveraging advanced biomarkers, companies could deliver more effective treatments faster than ever before.

As AI continues to evolve, its role in biotech will only expand, according to O’Day. From drug repurposing—where AI finds new applications for existing medicines—to real-time patient monitoring, AI is set to revolutionize healthcare.

“AI is totally transforming every aspect of our business,” he said. While AI is a powerful tool, collaboration between data scientists, biologists, and healthcare professionals remains essential, according to O’Day, who added that, “Applying AI models will only get you so far.”

By integrating AI with cutting-edge research, the industry is moving closer to a future where treatments are more precise, efficient, and accessible than ever before.

Watch a video of the event:

This article was generated with the assistance of AI and subsequently reviewed and refined by a human editor to ensure accuracy, clarity, and coherence.