Pharmaceuticals
Cover photo: Myriam Zilles/Unsplash

Pharmaceuticals

Reducing the impact of the procurement of pharmaceuticals

  • Medical items
  • Medical procurement
  • Procurement
  • Medicine

By changing how medical facilities prescribe, purchase, and administer pharmaceuticals, emissions from pharmaceuticals can be reduced while maintaining patient health and quality care.

Why is this important?

The production, distribution, and use of pharmaceuticals accounts for around 25% of the greenhouse gas emissions produced by the health care sector. (1) For a typical medical organisation from the international aid sector, pharmaceuticals make up roughly 3.5% of their total carbon footprint, and 13% of the footprint of purchases. (2)

As populations age and the demand for prescriptions rises, these emissions are likely to increase further. (3) This growing demand emphasises the urgent need to adapt procurement practices to protect patient health while keeping emissions low.

What's the solution?

Reducing emissions from the procurement of pharmaceuticals involves integrating sustainability into the procurement process, selecting suppliers and materials that contribute to a greener supply chain, such as using renewable energy, and requesting detailed carbon footprint information at the item level. This will allow for informed decisions, favouring products with the lowest environmental impact.

Addressing over-prescription is also crucial. By implementing precise prescribing practices, emissions from the production, transportation, and disposal of unused medications can be avoided. By adopting these strategies, healthcare facilities can significantly reduce its carbon footprint.

  • Point of attention

    One of the most effective levers for reducing emissions in pharmaceutical supply chains is the transition to renewable energy in the production process. Shifting to renewable energy could reduce emissions by 20% to 30% across the supply chain. (4)

    Many drugs, especially specialised medications, have one or few suppliers so hospitals have little leverage to change the practices of pharmaceutical companies. Collaborating with other hospitals and pharmaceutical prescribers can add incentive and bargaining power to change these practices. (5)

Key figures

4.4%

Healthcare’s share of global greenhouse gas emissions. (6)

25%

Medicines account for 25% of the NHS’s carbon footprint. (7)

50% to 80%

of greenhouse gas emissions from drug supply chains occur at the level of upstream suppliers. (8)

40%

NHS target to reduce emissions from anaesthetic gases by switching to lower carbon alternatives and improving anaesthetic practice. (9)

127

Pharmaceutical Biotechnology and Life Sciences companies that have climate targets validated by the Science Based Targets Initiative. (10)

55%

The pharmaceutical industry emits 55% more CO2e than the automotive industry for every $1 million it generated in revenues in 2019. (11)

Key actions

  • #1 Reduce overprescription

    Minimise prescription of unnecessary medication. Studies show that 10% of the items dispensed in primary care were not needed, so critically evaluating the necessity of medicine can improve prescription practices and reduce emissions. (12)

  • #2 Use alternatives, where possible

    Switch to alternative products or less emissive delivery options. For example, use less emissive anaesthetic gases or inhalers. (13)

  • #3 Prefer suppliers with a decarbonisation plan

    Select suppliers with a decarbonisation strategy, preferably those that have their targets validated by the Science Based Targets initiative (SBTi). SBTi is a non-profit organisation that reviews corporate climate targets and provide validation to those that are aligned with the ambitions of the Paris agreement. (14) Question suppliers about their decarbonisation plans (renewable energy, process optimisation, etc.).

  • #4 Prefer suppliers that optimise their processes

    Question suppliers on the measures they take to improve efficiency in manufacturing processes, e.g. continuous improvement of manufacturing practice, moving towards continuous manufacturing, increase electricity efficiency, solvent recycling and reuse, and applying green chemistry principles. (15)

  • #5 Prefer suppliers that use renewable energy

    Select suppliers that are using renewable energy on their production sites. The use of renewable power can lead to a reduction of greenhouse gas emissions by 20-30% across supply chains. (16)

  • #6 Request product carbon footprints or LCAs

    Ask suppliers to provide a product carbon footprint or a lifecycle analysis. Some advanced suppliers might already be able to supply the information. Use the information to identify decarbonisation levers and prefer suppliers that address them. The British Standard Institution (BSI) is in the process of developing a harmonised methodology to measure greenhouse gas emissions in the pharmaceutical sector. (17)

  • #7 Switch to less wasteful and emissive packaging

    Work with suppliers to reduce the impact of packaging, where possible. Prefer reduced packaging and seek alternatives to plastic packaging. Consider primary and secondary packaging.

Simone van der Koelen/Unsplash

To consider

  • Potential co-benefits

    • Reduced operating costs: Lower overall expenses due to more efficient practices.
    • Reduced procurement costs: Decreased spending on acquiring medicines and supplies.
    • Reduced medicine waste: Minimised waste from expired or unused medications.
  • Success conditions

    • Change in prescription behaviours: Encouraging practitioners to alter their prescribing practices.
    • Decarbonisation plans: Implementation of sustainability plans by pharmaceutical companies.
  • Prerequisites & specificities

    • Pharmaceutical tracking: Implementing systems for tracking pharmaceutical use and waste.
    • Collaboration with the medical community: Building support through cooperation with healthcare professionals.
    • Standardised tools and emissions factors: Adoption of common tools and metrics for measuring emissions.
  • Potential risks

    • Slow adoption time: Potential delays in uptake due to high levels of industry regulation.
    • Availability of alternatives: Challenges in finding or accessing suitable alternative solutions.

Success stories

NHS: “Only order what you need” campaign

Dorset ICB’s (Integrated Care Board) sustainability campaign to reduce overprescribing led to a 2% drop in prescription requests across the board, with up to 16% reductions in the most engaged practices. The campaign saved an estimated £555,091 in prescription costs and reduced carbon emissions by 344,712 kg CO2e.

Sustainable market Initiative: Joint Supplier Targets

A short document with a set of joint environmental targets for suppliers and the timeline by 2025 and after. The health systems task force is made up of suppliers like Samsung Biologics, Sanofi, GSK, and more.

NHS: Phasing out desflurane

The use of anaesthetic gases contributes 2% of the NHS’s carbon footprint. (18) The NHS, supported by the Royal College of Anaesthetists and the Association of Anaesthetists, decided in early 2023 to phase out desflurane. Desflurane has a particular high global warming potential that is 2,500 times greater than CO2. The decision will save 40,000 t of greenhouse gas emissions a year. (19)

GlaxoSmithKline: New Less Emissive Inhalers

Metered dose Inhalers (MDI) have a high environmental impact because they contain hydrofluorocarbons (GHGs). Even though ozone-depleting chlorofluorocarbons were phased out in the 1990s modern inhalers still are emissive. For GlaxoSmithKline (GSK), a leader in respiratory medicine, 45% of all its emissions comes from MDIs so they are developing a lower-emission propellant that could reduce inhaler GHG emissions by 90%. (20)

Tools and good practices

  • Climate Action Accelerator Webinar, Procurement of pharmaceuticals: How can buyers make more sustainable choices?, 2023

    This webinar discusses the current state of efforts in the pharmaceutical industry to reduce its carbon footprint and will provide actionable insights on how buying organisations can make a positive impact through sustainable procurement practices.

    Watch here
  • BSI, Sustainable design and assessment of medicines

    BSI is convening the development of a standard to drive consensus on an ecosystem-wide methodology standard for the calculation of carbon footprints of pharmaceutical products.

    Read here
  • Sustainable Packaging Guide for the pharmaceutical sector, 2019

    A tool providing tips and examples for making medicine packaging more sustainable. It provides goals and a checklist with general ideas for packaging for each subtopic: prevention, reduction, recycling, and material choice.

    Explore here

To go further

  • Health Care Without Harm, Procuring For Greener Pharma, 2022

    Outlines the challenges of sustainable procurement in pharma and provides case studies and recommendations for more sustainable models.

    Read here
  • Sustainable Markets Initiative, Decarbonising Healthcare Supply Chains, 2022

    Recommendations on how to reduce emissions in 9 aspects of the healthcare supply chain.

    Read here
  • Reducing Opioid Overprescribing by Educating, Monitoring and Collaborating with Clinicians: A Quality Improvement Study, 2020

    A study outlining how clinicians can reduce over prescription. This study can be used as a guide for other pharmaceutical proscription practices. It focuses on educating providers as a key way to advocate for change.

    Read here

Last updated 12 September 2024.

Share your success stories, suggestions, and comments with us! contact@climateactionaccelerator.org 

Sources

(1) P. Boyle, “Drugs used in hospitals leave giant carbon footprint”, AAMC, 2024. Available here (accessed 10 June 2024).

(2) MSF and Climate Action Accelerator, “MSF OCG Carbon Footprint Report 2019”, 2022, p. 19. Available here (accessed 4 September 2024).

(3) Sustainable Markets Initiatives, “Decarbonising Healthcare Supply Chains”, 2022. Available here (accessed 25 June 2024).

(4) Sustainable Markets Initiatives, “Decarbonising Healthcare Supply Chains”, 2022, p. 11. Available here (accessed 25 June 2024).

(5) P. Boyle, “Drugs used in hospitals leave giant carbon footprint”, AAMC, 2024. Available here (accessed 10 June 2024).

(6) Health Care Without Harm, “Health Care’s Climate Footprint”, 2019, p. 19. Available here (accessed 24 July 2024)

(7) NHS, “Delivering a ‘Net Zero’ National Health Service”, 2020, p. 31. Available here (accessed 25 June 2024).

(8) Sustainable Markets Initiatives, “Decarbonising Healthcare Supply Chains’, 2022, p. 8. Available here (accessed 25 June 2024).

(9) NHS, “Delivering a ‘Net Zero’ National Health Service’, 2020, p. 31. Available here (accessed 25 June 2024).

(10) Science Based Targets, “Companies taking Action”. Available here (accessed 4 September 2024).

(11) World Economic Forum, “6 ways the pharmaceutical industry can reduce its climate impact’, 2024. Available here (accessed 10 June 2024).

(12) E. Mahase, ‘Overprescribing: 10% of items dispensed in primary care are inappropriate, review finds’, BMJ, 2021. Available here (accessed 25 June 2024).

(13) Sherman, Jodi, Le, Cathy, Lamers, Vanessa et al., ‘Life cycle greenhouse gas emissions of anesthetic drugs’, Anesthesia and analgesia, 2012, p. 1086–90, (accessed 6 September 2024).

(14) Booth, Amy, Jager, Alexandra, Faulkner, Stuart D. et al., ‘Pharmaceutical Company Targets and Strategies to Address Climate Change: Content Analysis of Public Reports from 20 Pharmaceutical Companies’, International Journal of Environmental Research and Public Health, 2023. Available here (accessed 6 September 2024)

(15) Sustainable Markets Initiatives, “Decarbonising Healthcare Supply Chains”, 2022. Available here (accessed 25 June 2024).

(16) Sustainable Markets Initiatives, “Decarbonising Healthcare Supply Chains”, 2022. Available here (accessed 25 June 2024).

(17) BSI, “The Design and Assessment of Sustainable Medicines”, 2024. Available here (accessed 4 September 2024).

(18) NHS, “NHS organisations cut desflurane in drive for greener surgery”. Available here (accessed 12 September 2024).

(19) Healthcare Without Harm, “UK healthcare leads the phase-out of desflurane – a potent greenhouse gas”, 2023. Available here (accessed 12 September 2024)

(20) J.K. Iyer, ‘6 ways the pharmaceutical industry can reduce its climate impact’, World Economic Forum, 2022. Available here (accessed 10 June 2024).

Cover photo: Myriam Zilles/Unsplash