Gilead Sciences (GILD 0.28%) and Johnson & Johnson (JNJ 0.57%) have competed against each other for years in the HIV market. The clear winner in that battle has been Gilead. J&J could also soon have Gilead nipping at its heels in the immunology market. 

But the decision between these two big healthcare stocks involves more than just looking at the areas where Gilead and Johnson & Johnson compete directly against each other. Here's how these two companies compare overall.

Female scientist holding two test tubes in a lab

Image source: Getty Images.

The case for Gilead Sciences

We've already mentioned Gilead's victory over J&J in the HIV market. The reality is that Gilead has been dominant over all the other players in HIV for a long time. And that streak isn't about to end anytime soon.

Gilead's Biktarvy is on track to generate sales of $4 billion or more this year. The HIV drug seems likely to achieve peak annual sales of at least $6 billion. Some of that growth is coming at the expense of Gilead's other HIV drugs. But the recent FDA approval of Descovy as preexposure prophylaxis (PrEP) HIV therapy will likely boost sales for the drug.

While Gilead's HIV juggernaut rocks on, the biotech's cancer cell therapy Yescarta is gaining momentum with sales nearly doubling year over year in the second quarter. New Gilead Sciences CEO Dan O'Day stated at the Morgan Stanley Global Healthcare Conference in September that the company is "fully committed to cell therapy" and intends to expand its leadership in the arena.

Although the heady growth days for Gilead's hepatitis C virus (HCV) franchise are in the past, the good news is that sales appear to have stabilized. The company shouldn't have to worry about its HCV drugs dragging down its overall performance going forward.

One huge key to that future performance is filgotinib. Gilead plans on filing soon for regulatory approval in the U.S. for filgotinib in treating rheumatoid arthritis. With other indications potentially on the way as well, Gilead could be looking at peak annual sales in the ballpark of $4 billion and perhaps even higher. 

Gilead also remains cautiously optimistic about its prospects in treating nonalcoholic steatohepatitis (NASH) despite some previous clinical setbacks with selonsertib. The biotech is evaluating two experimental NASH drugs in phase 2 clinical studies. Results from those studies will dictate what next steps Gilead takes in the potentially lucrative indication.

Don't be surprised if Gilead adds to its pipeline. The company claims the biggest cash stockpile among biotechs. Gilead is using some of its cash to expand its immunology collaboration with Galapagos. It also remains committed to its dividend program, with the dividend currently yielding more than 4%.

The case for Johnson & Johnson

Johnson & Johnson ranks as the biggest healthcare stock on the market. And it's not a close contest. J&J is one of the largest drugmakers in the world. It's one of the largest medical device makers. It's also one of the biggest consumer health products companies. Its broad scope makes J&J one of the most diversified healthcare stocks around. 

However, J&J's pharmaceutical segment is definitely its biggest moneymaker. The company claims a varied lineup of drugs on the market, including immunology blockbusters such as Remicade, Tremfya, Simponi, and Stelara, along with cancer blockbuster drugs Darzalex, Imbruvica (which J&J co-markets with AbbVie), and Zytiga.

Several of these top-selling drugs continue to enjoy solid sales growth, particularly Darzalex, Imbruvica, and Tremfya. J&J should also have a big winner on its hands with depression drug Spravato. On the other hand, J&J also faces declining sales for some of its key drugs, especially Remicade.

Johnson & Johnson's drug pipeline is loaded with late-stage candidates. Many of these programs are targeting additional indications for already-approved drugs. However, J&J also has several new products potentially on the way, notably including multiple sclerosis drug ponesimod and a couple of experimental multiple myeloma therapies.

The company's medical device segment comes in second behind pharmaceuticals in total revenue generated. This segment hasn't delivered great results for J&J in recent quarters. But one bright spot is atrial fibrillation devices. J&J also could benefit from its acquisition earlier this year of robotic surgical systems maker Auris Health.

Consumer health hasn't been a tremendous winner for J&J lately, either. The segment's beauty products continue to deliver solid sales growth, though, helped by acquisitions. Competition remains intense in the overall consumer health market.

Even with less-impressive performances for its consumer health and medical device units, J&J still generates solid cash flow. It also uses its strong financial position to reward shareholders with steady dividends and share buybacks. The company's dividend currently yields a little under 3%, with J&J increasing its dividend for 57 consecutive years.

Better buy

Which of these two stocks is the better pick? I think that it depends on what type of investor you are.

More conservative investors will be better off going with Johnson & Johnson. The healthcare giant's diversification reduces the risks that are associated with investing in biotech stocks like Gilead.

However, I think that aggressive investors will probably like Gilead over J&J. With Biktarvy and Descovy leading the way in HIV, sustained momentum for Yescarta, and tremendous potential for filgotinib, Gilead could be at the cusp of a significant comeback following several years of decline caused by its HCV franchise.