Presentation (CTI)

OBJECTIVES: Pharmaceutical innovations are frequently viewed as costs to healthcare systems, while broader societal returns are not systematically considered. Using HIV as a case study for the Netherlands, this research aimed to assess the long‑term societal value generated by investing in HIV care with a focus on anti-retroviral therapies (ART) and identifying remaining challenges that limit progress towards HIV elimination.
METHODS: A mixed-method approach was conducted using publicly available epidemiological, clinical, healthcare databases, cost, and labour market data for the Netherlands, complemented by insights from interviews with healthcare professionals, people with HIV, and patient organisations. Quantitative analyses estimated avoided HIV infections and HIV/AIDS‑related deaths, healthcare resource use, direct medical costs, and productivity effects over a time span of ~35 years (1987-2023). Qualitative findings were used to contextualise quantitative results and to identify persisting gaps.
RESULTS: Innovation in HIV care has generated substantial societal gains in the Netherlands. At least 5,300 new HIV infections and more than 13,000 HIV/AIDS‑related deaths have been prevented, alongside improved health‑related quality of life, and simplified treatment regimens. Although ARTs introduced direct medication costs, these were offset by reductions in non‑drug healthcare utilisation, resulting in over €143 million in avoided direct medical costs. Healthcare resource use declined by approximately 3.6 million working hours, equivalent to 91,000 FTEs. At a societal level, productivity gains from prevented deaths corresponded to an estimated €8.4 billion in additional labour income. Despite these gains, rising of new infections, stigma, late diagnosis, and the absence of curative treatment remain key challenges.
CONCLUSIONS: Overall, the results demonstrate that pharmaceutical innovation in HIV has been a long‑term societal investment in healthcare, generating value for patients, healthcare systems, and society. Challenges nevertheless remain. Continued investment in innovation is essential to address persistent clinical and societal challenges in HIV and to support progress towards ending this epidemic for everyone everywhere.