Challenges and recommendations for environmental sustainability assessments of pharmaceutical products in the healthcare sector

Abstract

With healthcare representing a significant portion of the global economy, it is important to be able to understand the environmental impacts of this industry due to its size and nature of its operations. Interviews with people who have intimate knowledge of the healthcare industry indicate that significant efforts and advances have been made over the past ten to fifteen years in developing environmental impact assessment methods and tools tailored for the sector. These methods and tools have been important in helping to improve the overall environmental sustainability of the sector. However, comprehensive literature searches reveal that only a limited portion of the environmental impact assessment work has been published and/or is publicly available. This lack of visibility to the full scope of environmental impact assessment methods and the results of application of those methods can impair the advancement of these methods. To help facilitate further advancement of environmental assessment methodologies in the healthcare sector, Ghent University and the European Commission's Joint Research Centre, Sustainability Assessment Unit (JRC IES SA) undertook a study to map current challenges in conducting assessments, identify best practices in assessing and advancing the state-of-the-art, and to develop recommendations and priority action points based on the study learning. The study was accomplished through: (1) conducting a thorough literature review; (2) broad engagement of healthcare sector stakeholders, including industry, academia, NGOs, policy makers, GPs, patients, etc.; (3) execution of a stakeholder survey; (4) expert interviews; and (5) roundtable discussions with sustainability professionals in the field. Upon identifying the bottlenecks in current practices, four recommendations and key action points were determined: (1) the integration of the complete healthcare pathway within system boundaries; (2) the establishment of life cycle databases for pharmaceuticals and supplied resources; (3) the integration of LCA calculations directly into Enterprise Resource Planning (ERP) systems to work with primary data as much as possible; and, (4) the need to further harmonize developments in the field. The authors provide suggested actions to address the recommendations and propose this work as guidance to steer further research and developments in academia, industry and policy environments in order to serve and support decision making processes

Potential for industrial ecology to support healthcare sustainability: Scoping review of a fragmented literature and conceptual framework for future research

“…Previous limited reviews have been conducted in this space—for example, a review of recycling and waste management practices by Kwakye et al. (), a review of environmental sustainability in hospitals (mostly focused on what are considered “foreground” activities in our framework) by McGain and Naylor (), a review of pharmaceutical sustainability by De Soete, Jiménez‐González, Dahlin, & Dewulf (), and a review of environmental considerations in health technology assessment by Polisena, De Angelis, Kaunelis, & Gutierrez‐Ibarluzea (). Nonetheless, to the best of our knowledge, our review is the broadest survey to date—using a wide range of keyword searches—of this fragmented literature.…”

Modeling pharmaceutical emissions and their toxicity‐related effects in life cycle assessment (LCA): A review

“…The search was further limited to case studies performed over the last 20 years. This timeframe was chosen because existing reviews on the evolution of LCA‐application in the pharmaceutical industry have indicated the late 1990s to be the period in which the first pharma‐LCAs appeared (De Soete et al ).…”

“…With regard to the first gap relating to the lack of LCI data for API production in common LCI databases, pharma‐LCAs have so far used diverse tools (e.g., the FineChem tool [Wernet et al ] and fast LCA of synthetic chemistry [FLASC] [Curzons et al ]) and several approaches (e.g., building chemical trees) to estimate gate‐to‐gate inventories of chemicals (Jiménez‐González et al ; Jiménez‐González et al ; Ott et al ), which provide first solutions to compile process data and build inventories for pharma‐LCAs. As recommended by De Soete et al (), in the long‐run, however, LCI databases for pharmaceuticals and supplied resources (excipients, solvents, etc.) using black box data (i.e., aggregated data sets) will have to be established by third‐party companies or organizations such as the European Federation of Pharmaceutical Industries and Associations to manage and supply reliable LCI data for the pharmaceutical industry.…”

“…Several tools and methods have been developed to help estimate and assess the effects of chemical releases into the environment. In this context, life cycle assessment (LCA) and life cycle impact assessment (LCIA) models are increasingly gaining acceptance as efficient tools to determine and compare the potential effects of different chemical products, including pharmaceuticals, and characterize their emissions into the environment in terms of their human toxicity and ecotoxicity potential (De Soete et al ; Fantke and Ernstoff ). Several review papers have been published on LCA‐application in the pharmaceutical, healthcare, and/or green chemistry sector.…”

“…Several review papers have been published on LCA‐application in the pharmaceutical, healthcare, and/or green chemistry sector. They provide a broad overview on common methodological practices (e.g., choice of functional unit) and on widespread challenges in conducting LCAs of pharmaceutical products (e.g., the lack of life cycle inventory [LCI] data for drug manufacturing processes and precursor chemicals) (Constable et al ; Jiménez‐González and Overcash ; Kralisch et al ; De Soete et al ). Likewise, numerous publications have reviewed the use of LCA in the field of wastewater treatment (WWT), revealing a growing trend in the inclusion of emerging contaminants—including PhACs—within the system boundaries of such analyses (Larsen et al ; Corominas et al ; Zang et al ).…”