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

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