On 15 May 2024, the Pharmacoeconomics Department at Gesundheit Österreich held a webinar on the topic of greener pharmaceuticals. The event informed about a range of policies along the pharmaceutical value chain which can mitigate the detrimental effects of pharmaceuticals on the environment, such as in the areas of health technology assessment, procurement and use, and offered research findings and best practice examples from European countries. The webinar took place in the framework of the European Public Health Week – Health is a political choice and was organised as part of Horizon Europe ASCERTAIN.
Pharmaceuticals play an important role in transitioning towards a planetary health approach: they currently make up a large share of the carbon footprint of health systems, and their manufacturing and improper disposal can negatively impact on finely balanced eco systems. These negative impacts pose challenges for achieving sustainable health care, but they also provide opportunities for introducing policies that make the production, procurement, and use of pharmaceuticals more environmentally friendly. Gesundheit Österreich invited to a webinar on the topic of greener pharmaceuticals, with the aim of learning about a range of policies along the pharmaceutical value chain which can mitigate the detrimental effects of pharmaceuticals on the environment.
The webinar focused on policy measures that already exist as part of pharmaceutical systems, including health technology assessment (HTA) and public procurement of medicines, and explored how these can be used to transition towards more sustainable health systems. It was informed by research findings into assessing environmental impacts of medicines and the experience of three countries (Austria, Denmark and the United Kingdom) in introducing policies and initiatives to promote “greener” pharmaceuticals.
KEY LEARNINGS OF THIS WEBINAR
Maximilian Salcher-Konrad (GÖG - Austrian National Public Health Institute)
Maximilian Salcher-Konrad, who facilitated this webinar, outlined possible policy levers (including in production, marketing authorisation, tendering or use) for promoting more sustainable pharmaceuticals along the pharmaceutical value chain (which describes the pathways of a medicine from research and development to use).
>> Acknowledgments and Agenda <<
Nadine Henderson (OHE - Office of Health Economics)
Nadine Henderson presented findings and recommendations on how to promote “greener” pharmaceuticals of an OHE report for the UK government, which is committed to achieving a Net Zero health system by 2040 (NHS carbon footprint target for directly controlled emissions). The report outlined a range of different types of incentives, mainly targeted at pharmaceutical industry, to encourage change: financial incentives, regulatory incentives, reputational incentives, collaborative incentives as well as pricing, reimbursement and procurement policy incentives.
>> The role of pharmaceuticals in achieving net zero: greener pharmaceuticals in the UK <<
Oliver Gröne (OptiMedis / University Witten/Herdecke)
The subsequent presentation addressed methodological challenges in considering environmental aspects in HTA, which had also been mentioned in the previous intervention. Oliver Gröne presented different methodological approaches and the application of these approaches in various use cases, based on a scoping review. One of the major challenges is lack of data but the review also highlighted that the field is evolving, solutions are being developed and some good practice examples of HTA incorporating environmental aspects exist.
>> What role for environmental impacts of pharmaceuticals in HTA? Overview of an evolving evidence landscape <<
Sofie Pedersen (Amgros)
Sofie Pedersen from the Danish procurement agency Amgros, which conducts centralised procurement of medicines and medical devices for public hospitals, highlighted the feasibility of awarding environmental aspects in tendering, as shown by two practical examples: An international standard (AMRIA) on antibiotic manufacturing, which aims to reduce developing antibiotic resistance and aquatic ecotoxicity in the environment, was included in national tenders as well as in a cross-country joint tender of the Nordic countries; and reducing packaging waste was considered as another award criterion in tenders. Sofie Pedersen informed that inclusion of environmental aspects in the tenders has neither resulted in higher costs nor in supply issues.
>> Sustainability criteria in the public procurement of medicines: experience from national tenders in Denmark and the joint Nordic tenders <<
Ruperta Lichtenecker (GÖG - Austrian National Public Health Institute)
The presentations and the discussions confirmed challenges in incorporating environmental aspects in various activities related to medicines as well as progress made. While robust methodological approaches are yet being explored and tested and the data availability is to be improved, several inspiring examples show-cased the feasibility of initiatives and moves towards “greener pharmaceuticals” in different stages of the pharmaceutical value chain. The importance of multi-stakeholder coordination and collaboration was stressed.
>> Transitioning towards an environmentally sustainable health system: experience from Austria <<
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Nadine Henderson is a Principal Economist at the Office of Health Economics in London. Her research interests centre around the measurement of the value of health and healthcare, resource allocation decisions and the environmental sustainability of the pharmaceutical industry and health systems. She holds an MSc in Health Economics from the University of York and a BSc in Economics from Lancaster University.
Prof. Dr. Oliver Gröne, PhD MSc, is Vice Chairman of the Board at OptiMedis AG, responsible for the areas Analytics, Research & Innovation. He is also Co-Founder and Director Population Health of OptiMedis-COBIC UK. From 2011 to 2015 he was Senior Lecturer in Health Services Research at the London School of Hygiene and Tropical Medicine, where he developed novel methods for assessing and improving the quality of care. As senior methodologist at the Royal College of Surgeons of England he led the implementation of large-scale national clinical audits on the quality and safety of care, in particular the field oesophago-gastric cancer. Prior to that, he led the “Quality of Health Systems” Programme at the World Health Organization Regional Office for Europe and served as Director of Research & Education at the Avedis Donabedian Institute, Autonomous University of Barcelona. He is a regular contributor to top-tier journals and was associate editor of the International Journal for Quality in Health Care from 2015-2020.
Sofie Pedersen is an Environmental Senior Specialist in Amgros, the Centralized Procurement Organization for hospital medicines in Denmark, owned by the Danish Health Regions. Sofie is responsible for Amgros' sustainability strategy and works tirelessly on promoting sustainability in Amgros' business and daily operations through dialogue and collaboration with colleagues and stakeholders at Amgros. Sofie has 15+ years of experience with sustainable business strategies, sustainable public procurement, corporate social responsibility (CSR) and sustaina-ble development focusing on rights from public sector, private sector and civil society.
Ruperta Lichtenecker, PhD has been Head of Department of the Competence Center Climate and Health – Department Climate Neutrality and Sustainable Transformation at Gesundheit Österreich GmbH since March 2022. Ruperta Lichtenecker has more than 30 years of experience as an economist, researcher, manager and supervisor in the fields of science, administration, economics and politics. She is the author of publications on the environment, climate, health, research and innovation and holds a master’s degree and PhD in macroeconomics from the Johannes Kepler University Linz.