Medical devices are critical to the diagnosis, treatment, and monitoring of patients in the healthcare sector. While they play a vital role in patient care, their production and use have significant environmental impacts. The healthcare industry produces 9% of the US’s greenhouse gas emissions and generates 7,000 tons of waste per day1. In the UK, medical equipment accounts for 10% of the total NHS carbon footprint – equivalent to the carbon footprint of all NHS patient, staff and visitor travel combined and double that of NHS water and waste15. Developing and using eco-friendly medical devices is becoming increasingly important due to the environmental impact of healthcare. Some governments, public healthcare systems and large purchasing groups, such as hospital networks are incorporating sustainability criteria into their procurement processes to address its carbon footprints, considering factors such as energy efficiency, recyclability, and waste reduction when evaluating and selecting medical devices. These organizations are leveraging their collective purchasing power to drive demand for eco-friendly medical devices16.
Therefore, there is a need for eco-friendly medical devices, so the industry can significantly reduce its carbon footprint and promote a more sustainable healthcare system.
Whilst this is highly dependent on the device, making a medical device eco-friendly can be categorized broadly into the following:
1.Being made from sustainable materials
Many medical devices are made from plastic2, which are not biodegradable. Alternative materials such as bioplastics, derived from renewable sources such as cornstarch and sugarcane, all which are being researched3. Bioplastics showing promise include polyurethane [PU] and poly[lactic acid] [PLA]17.
2. Consume less energy
Devices can also be optimized to run on rechargeable batteries, reducing the number of disposable batteries that end up in landfills. Eco-friendly paper-based fuel cells are another offering using energy generated via enzymatic reactions and stored using glucose and oxygen, avoiding the use of toxic materials and environmental pollution long after the batteries have been discarded4.
3. Be extended through their optimization, for reuse and recycling
By designing devices that are easy to disassemble, repair, and reuse, manufacturers can reduce the amount of waste generated during the device’s lifecycle. Furthermore, devices can be recycled at the end of their lifecycle, reducing the need for virgin materials in the production of new devices5.
Examples of medical devices in rapidly expanding markets, subsequently having a growing environmental impact, are autoinjectors and inhalers. There are approximately 1.25 billion inhalers manufactured and 127 million autoinjectors sold each year. Growing interest in personalized medicine and the increasing use of biologic therapies18, as well as expanded access to treatments that improve patient care and flexibility support continued growth in these markets14.
In 2025, auto injectors are expected to produce 80,000 tonnes of plastic waste, with inhalers not far behind with 55,000 tonnes14. Disposal of used insulin pens by millions of people worldwide contribute to environmental pollution. To address this, Novo Nordisk developed the NovoPen Echo6 and NovoPen Echo Plus7 reusable insulin pens, made with fewer components and are designed for easy disassembly, making them easier to recycle8. Novo Nordisk has also implemented the “Pen-Cycle” initiative to collect used pens, which are disassembled, and the components are recycled9. These pens are one element of Novo Nordisk’s commitment to not only developing eco-friendly devices, but to also promote sustainability in the healthcare sector.
Another example of an eco-friendly device is the Breezhaler inhaler, which is used to deliver medications for chronic obstructive pulmonary disease [COPD]11. Developed by Novartis, one of the key features of the Breezhaler is its design, which eliminates the need for a propellant to deliver the medication. Traditional metered-dose inhalers [MDIs] use hydrofluoroalkane [HFA] propellants, a potent greenhouse gas contributing to global warming. In contrast, the Breezhaler uses a dry powder formulation delivered using a breath-activated mechanism, eliminating the need for a propellant. This reduces the inhaler’s carbon footprint and makes it a more sustainable option12. Like Novo Nordisk’s insulin pens, the Breezhaler design allows for component recycling, offered at local UK pharmacies13, allowing a more sustainable approach to traditional inhalers.
While there may not be specific regulatory requirements now, the industry is evolving. Healthcare devices are major contributors to environmental impact, with governments looking across sectors to reduce its own impact – healthcare will and must be part of that action. Therefore, either through direct regulation or preferred purchasing – medical devices will be impacted.
For example, the NHS is leveraging its purchasing power to create demand for sustainable products and is targeting a net-zero NHS and supply chain by 2045. As an example, NHS England are remanufacturing and restoring medical devices to ‘as new’ condition19. Subsequently, the pharmaceutical industry will need to adjust and therefore influence developers to adhere to new sustainable trends. It is important to note that initiatives requiring extensive R&D, changes in formulation and regulatory approval may entail long payback periods and uncertainty in return of investment14. However, favorable results can be seen. For example, in a project conducted in collaboration with CHR and the MPhil Therapeutic Sciences program at the University of Cambridge, a hypothetical business case [DCF model] below was created to illustrate how low-risk product sustainability may work. It shows the potential of an eco-friendly auto-injector vs present value, whilst gaining a vast more market share as a sustainable company.
Figure 2: Modelling the projected net present value and projected market share of a sustainable auto-injector14
In conclusion, the healthcare sector has a significant environmental impact, and eco-friendly medical devices are an important pillar pharmaceutical companies will have to consider within a changing landscape towards reducing environmental impact. By using methods such as utilizing sustainable materials, optimizing devices for energy efficiency, and designing them for reuse and recycling, the pharmaceutical industry can help build a more sustainable healthcare system. Pharmaceutical companies should encourage manufacturers to consider environmental impacts, such as energy efficiency, waste reduction, and materials selection, when designing and developing medical devices. Healthcare providers and policy makers should encourage the production and use of eco-friendly medical devices to promote sustainability and reduce the environmental impact of the healthcare sector. Given the length of time to develop, regulate and market sustainable medical devices, change will be needed imminently.
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