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HIV Spending Trends
Sustaining Patient Care and Innovation in HIV
Nov 06, 2025
Report Summary:
Over the past four decades, HIV treatment and prevention have advanced dramatically through effective antiretroviral therapies (ART) and pre-exposure prophylaxis (PrEP), transforming HIV into a manageable chronic condition. In 2024, 40.8 million people were living with HIV, with 31.6 million receiving ART.
Despite this progress, unmet needs persist—especially for vulnerable populations facing stigma, fragmented care, and adherence challenges. Drug resistance remains a global concern, underscoring the importance of long-acting ART and new mechanisms of action. While an effective vaccine or cure is still out of reach, sustained research funding is critical.
However, declining R&D activity, cost-containment policies, and flat spending in key markets threaten continued innovation and equitable access. Ongoing dialogue among stakeholders is vital to sustain investment, protect innovation, and advance the goal of ending the HIV epidemic.
This report highlights some of the main unmet needs in HIV and challenges with developing treatments to address them. It also captures the dynamics around research and development (R&D) along with spending and healthcare policy which can have an impact on the development of and access to future HIV treatments.
Key Findings:
From an R&D perspective, HIV clinical trial starts have been flat at approximately 90 per year since 2020, down from the average 150 a year the decade prior.
Global spending at manufacturer list price level on HIV medication has been increasing over the past decade with spending in the U.S. driving the growth. However, growth in Europe has been flat over the past 10 years, declining on average 0.1% annually.
Across a selected set of European countries along with Australia and Canada, HIV spending growth has largely been flat over the last decade and significantly lower than specialty and overall pharmaceutical drug growth.
Costs per defined daily dose of HIV treatments have been reducing across several countries in Europe even as spending has remained flat or grown marginally.