Biotech investors may still be getting over the shock of the departure of Gilead’s top two executives, but that hasn’t stopped analysts from speculating about who will be the troubled company’s next CEO.

Topping the list of a possible replacement for departing CEO John Milligan, Ph.D., is Jacqualyn "Jackie" Fouse, Ph.D., who had a seven-year stint as the chief financial officer and then chief operating officer at Celgene. That’s the suggestion from RBC Capital Markets analyst Brian Abrahams, who conducted an investor survey and revealed the results to investors in a note he sent out Monday.

Yes, Celgene had some troubles of its own during Fouse’s tenure, and she would have to relocate from the East Coast, but "given her track record (both vision and execution), relationship with the Street, and ability to attract talent, we believe her presence at [Gilead] would be well received," Abrahams wrote.

The news of Milligan’s departure, which was announced along with the retirement of chairman and former CEO John C. Martin, Ph.D., came during the company’s second-quarter earnings report last week. The financial results revealed a continuing downward slide for the company, which has been suffering from the rapid drop in demand for its hepatitis C stars Sovaldi and Harvoni. During the quarter, product sales fell 21% year over year to $5.6 billion, and earnings per share plummeted 40% to $1.39.

So does Fouse have the chops to engineer the turnaround Gilead so desperately needs? The company is counting on some of its newer products to drive revenue growth going forward, including CAR-T cancer therapy Yescarta, so her oncology background would certainly come in handy. Fouse joined Celgene as CFO in 2010, moving on to take over the company’s hematology and oncology unit, before being named president and COO in 2016.

Fouse left Celgene abruptly last February, after the company named Mark Alles as its new CEO. Fouse and Alles had apparently been competing to take over the C-suite from Bob Hugin, who retired to run for a U.S. Senate seat. Still, Fouse’s departure was a surprise, and some industry watchers speculated at the time that she would soon show up as CEO of another biotech company. Fouse reportedly turned down the opportunity to take over as CEO of Teva last August and she’s now executive chairman of Dermavant, a company that's developing a drug to treat excessive sweating and that recently bought the rights to a late-stage experimental drug to treat psoriasis and atopic dermatitis from GlaxoSmithKline.

Fouse was the winner of Abraham’s investor survey by a wide margin, though some other interesting names were proposed as good choices to lead Gilead. Some respondents suggested the company should find its next CEO via a merger, perhaps with Vertex (Jeff Leiden) or Pfizer (Ian Read). Others proposed that Gilead steal away the head of another big biotech company, such as Amgen CEO Bob Bradway or Roche Pharma CEO Daniel O’Day. Chief scientific officers might also be well-suited to take on Gilead’s challenges, some said, including Merck’s Roger Perlmutter and GlaxoSmithKline’s Hal Barron.

Gilead is expected to select a replacement for Milligan by the end of the year, when he is scheduled to step down. Martin plans to depart when the new CEO is named.

The prospect of such a radical change in the top ranks of Gilead has generated some agita on the Street. Leerink analyst Geoffrey Porges fears that "given the company’s mixed hiring record, the appointee may not necessarily be an individual with immediate industry or investor credibility," he wrote in a note to investors last week. Jefferies analyst Michael Yee acknowledged in a note that the change "brings uncertainty" in the short term.

Still, wrote Yee, the prospect of a "new" future for Gilead also offers hope for "more pipeline, more bold steps, more aggressive BD, and a chance for PE expansion and stock appreciation." Gilead’s decision to clean house may be nerve-racking, he wrote, but it could very well transform the company "from pharma-like, to more biotech-like."

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