HIV is now a manageable condition with antiretroviral therapy (ART), but treatment remains costly. In 2019, total HIV care expenditure in the Netherlands amounted to nearly €200 million, with 70% spent on medication. This thesis demonstrates that HIV care can be organized more efficiently without compromising quality. Generic HIV medication plays a key role. Since its introduction, annual medication costs per patient have dropped by more than twenty percent. In 2022 alone, generic tenofovir/emtricitabine resulted in €6.3 million in savings. When initiating treatment, a combination of two tablets—one of which is generic—offers a fully effective and more affordable alternative to widely used, more expensive single-tablet regimens. Ongoing treatments can also be adjusted cost-effectively, provided patients and healthcare professionals make decisions together. In contrast, a mandatory switch imposed by an insurer—without such involvement—led to higher costs. These findings highlight the importance of collaboration and shared decision-making in creating sustainable HIV care that balances quality and affordability.
Piter Oosterhof (1986) obtained his Master’s degree in Pharmacy from the University of Groningen in 2012 and subsequently worked as an outpatient pharmacist at OLVG Hospital in Amsterdam. In 2018, he began his PhD research at Radboud university medical center, within the Department of Pharmacy, in collaboration with OLVG. He is currently working as a hospital pharmacist at OLVG.