Some might argue that Gilead Sciences (GILD -0.56%) is back. The stock trounced the S&P 500 in 2022. Despite a slower start this year, Gilead appears to be in pretty good shape to resume its momentum.

The big drugmaker reported its 2022 full-year and fourth-quarter results after the market closed on Thursday. CEO Dan O'Day stated in the press release announcing the numbers, "2022 marked Gilead's strongest full-year growth in our base business since HCV sales peaked in 2015."

Is Gilead Sciences stock a buy after its strongest results in seven years?

Plenty of positives

There was a lot to like in Gilead's update. Perhaps the best news of all was on Gilead's bottom line in the fourth quarter.

The company reported that its diluted earnings per share (EPS) more than quadrupled year over year to $1.30. The growth wasn't quite as impressive on an adjusted basis. However, Gilead still posted adjusted diluted EPS of $1.67 in Q4, up 142% year over year and handily beating the consensus Wall Street estimate of $1.49.

Two of Gilead's HIV drugs again delivered strong growth. Biktarvy's sales jumped 15% year over year in Q4 to $2.9 billion. Fourth-quarter sales of Descovey increased 13% to $537 million.

Even the beaten-down HCV franchise performed well. Sales of Gilead's HCV drugs increased 12% year over year in Q4 to $439 million.

But investors were no doubt excited about Gilead's cancer drugs. Sales for cell therapy products Yescarta and Tecartus skyrocketed 75% year over year in Q4 to $419 million. Breast cancer drug Trodelvy's sales vaulted 65% higher in the quarter to $195 million.

Digging deeper

Is everything sunshine and roses in Gilead's world? Not really.

Note that O'Day qualified his statement about Gilead's growth being the best since 2015 by only referring to the company's "base business." That base business excludes Gilead's No. 2 best-selling product -- Veklury.

There's a good reason why O'Day didn't want to include Veklury. Sales of the COVID-19 therapy sank 26% year over year in Q4 to $1 billion. Coronavirus-related hospitalizations are trending downward, and Gilead projects Veklury sales of around $2 billion in 2023. That total is only a little over half of the therapy's 2022 sales.

Sales for the company's hepatitis B virus (HBV) and hepatitis delta virus (HDV) drugs also slid 4% year over year in Q4 to $255 million. Gilead attributed the decline to lower demand and pricing challenges outside of the U.S. market.

The big drugmaker projects 2023 total product sales of between $26 billion and $26.5 billion. Even the upper end of that range reflects a small year-over-year drop. More encouraging, though, Gilead expects strong earnings growth in 2023 that's higher than the average analyst estimate at the midpoint of the range.

A screaming buy?

Returning to our initial question: Is Gilead Sciences stock a screaming buy after its latest update? I suspect that shares could again beat the market this year if Gilead continues to top Wall Street's expectations. 

I also think that income investors will find Gilead attractive. The biotech company's dividend yield currently stands at nearly 3.5%. In its update on Thursday, Gilead announced another dividend increase of 2.7%. Since 2016, the company has increased its dividend by nearly 70%. 

However, my view is that Gilead doesn't qualify as a screaming buy. There are other stocks, including several biotech stocks, that I believe offer even more compelling risk-reward propositions. Still, it's great to see Gilead turning things around after years in the wilderness. For longtime shareholders, that should be worth getting excited about.