Increasingly, the companies on Wall Street that we cover are starting to agree that while the future’s still bright for the U.S. economy, the future may be one of stock market gains that are much lower than over the past 10 years. When that is the case, then investing strategies often shift from indexing to a more disciplined stock-picking routine, and that’s when investors need solid growth ideas.

Jefferies highlights the firm’s top growth stocks to buy each week, and recently four top biotech stocks made the cut. While these companies are better suited for accounts that have a higher risk tolerance, they all make good sense now, and all have outstanding upside potential.

Cara Therapeutics

This company has big clinical data coming in 2019. Cara Therapeutics Inc. (NASDAQ: CARA) is focused on developing and commercializing chemical entities designed to alleviate pain and pruritus by focusing on kappa opioid receptors. It is developing a class of product candidates that targets the body’s peripheral nervous system.

The company’s product candidate pipeline includes IV CR845 for acute pain, IV CR845 for uremic pruritus, oral CR845 for acute and chronic pain, and CR701 for neuropathic and inflammatory pain.

Jefferies is positive on the top product and the revenue potential:

CARA’s lead program IV Korsuva is for the treatment of chronic kidney disease on hemodialysis associated pruritus (CKD-HD-aP). There are ~180,000 patients which suffer from CKD-HD-aP and the FDA has not yet approved any drug for treatment. We currently model peak penetration of 27% and $573 million in peak-adjusted US sales. We expect the two ongoing Phase 3 trials to generate similar positive data based on the robust prior data (70% likelihood for positive data). Top-line Phase 3 data is due to read out in mid-2019 and should be a positive catalyst for shares.

The Jefferies price target for the shares is $30, and the Wall Street consensus target is $26.89. The stock traded early Monday at $22.95.

Gilead Sciences

This stock is trading a very reasonable 10.6 times estimated 2018 earnings. Gilead Sciences Inc. (NASDAQ: GILD) is a biopharmaceutical company that discovers, develops and commercializes therapies for the treatment of HIV/AIDS, liver disease, cancer and inflammation. The recent acquisition of KITE allows for entry into the CAR-T space, indicating a renewed focus in oncology.

The company’s products include Stribild, Complera/Eviplera, Atripla, Truvada, Viread, Emtriva, Tybost and Vitekta for the treatment of human immunodeficiency virus (HIV) infection in adults; and Harvoni, Sovaldi, Viread and Hepsera products for the treatment of liver disease.

The company posted solid clinical results recently, and Jefferies weighed in:

Gilead reported the first Phase 3 study for filgotinib in Rheumatoid Arthritis (RA), showing overall positive efficacy and safety, in line with high expectations. We see this as a modest but good catalyst for the company given recent stock under performance and would expect this to improve investor sentiment. We note that the next major Phase 3 RA studies read out during first half of 2019 and we would expect them to act as further catalysts for shares.

Jefferies has a $95 price objective, and the consensus target price is $88. They traded at $75.95 Monday morning.