“Climate change is the single biggest threat to our world and health.”
The International Pharmaceutical Federation’s address to the WHO
A recent episode of “The Business of Pharmacy” podcast made me think about the environmental impact and sustainability of a pharmacy. In the episode, Mike Koelzer interviewed Melinda Su-En Lee – a co-founder of Phill Box – about her company’s mission to make pharmacy packaging more sustainable. This made me think of the environmental impact and all the waste generated by the pharmacy industry.
I am very thankful to Mike and Melinda for bringing up this subject and for urging the listeners to take every step possible toward making a difference in their pharmacy, community, and the environment. I am surprised at how little is talked about the environmental crisis on the professional level where profits are being prioritized over the health of our planet that is on a verge of the environmental catastrophe. During the last state elections, I was eager to vote for those who prioritized environmental changes. But no candidate made it their number one priority. Most talked about job, safety, politics – which are all important things to address – but without healthy soil, air, water.. there would be nothing.
After the podcast, I googled “pharmacy sustainability” and most of the articles I found or policies on reducing pharmacy waste were coming from Canada or Europe. This country is still mostly silent about the elephant in the room. Climate change is the greatest threat to our health, our children’s future, and the planet. Yet, it is not prioritized in businesses, households, or in the U.S politics.
If greenhouse gas emissions rise more than 1.5C above pre-industrial levels, the planet’s ecosystem will start to collapse. (See Helmer’s article). If we do not reduce emissions by at least 40 percent by 2030 and get them to zero by 2050, we will pass that threshold in about seven years. Id.
So what could be done by the pharmacy industry?
– Choose equipment that uses energy efficient technologies (e.g. low or ultra-low GWP refrigerators)
– Reduce plastic pollution (that takes up to 1000 years to disintegrate)
– Use sustainable packaging
– Install drug take-back receptacles and remind patients to return their unused or expired medications
– Implement “green workplace” practices (less printing, recycling bins, no single use plastic in break rooms)
– Make better ordering choices. (e.g. a pharmacy can order 1 bottle of 500 tablets instead of 5 bottles of 100 tables)
– Ensure that patients do need their medications prior to refills
– Recycle certain devices and other materials (such as blister packs, while it is typically not recyclable, Terracycle has just implemented the medicine packet recycling program).
Just think of the potential impact some of these practices could make. With over 6 billion prescriptions filled each year in U.S., pharmacy environmental impact is a serious matter. While some may say that pharmacies with all regulatory compliance, audits, and low reimbursement rates simply do not have enough resources for reducing or even monitoring their environmental impact, I have to point out that most of the practices do not require much recourses (such as switching to more sustainable packaging vendors, or printing less, or ensuring patients still need their medications, etc.).
Pharmacies are heavy consumers of plastic and paper. I was surprised to find out that my county does not recycle pill bottles or other medication containers. Billions of them end up in landfills. I came across some statistics regarding pharmacy’s use of paper and the numbers are shocking. A single prescription uses the following paper products: the bag, the pamphlet, the label, the receipt. For example, in 2018, CVS used 54,500 tons of paper (See APhA’s post). How about switching to e-receipts/pamphlets and recycling stock bottles?
There is even a conference on reducing environmental impact of pharmaceutical industry – Clean Med Conference. There are also companies that specialize on greening pharmaceutical business (just google “pharmacy sustainability”) and additional resources on how pharmacies can reduce their carbon footprint:
- “How is your pharmacy supporting sustainability?” by Helmer Scientific
- International Pharmaceutical Federation’s Statement of Policy
- Royal Pharmaceutical Society’s environmental case studies
- “Pharmacy sustainability: What is our role?” by APhA
- “Considerations for Environmentally Conscious Pharmacy Students” by Pharmacy Times
- “Filling a greener prescription” by National Library of Medicine
- “Reducing Waste in Pharmacies” by EcoloPharm
- “Climate change at a crossroads: Embedding environmental sustainability into the core of pharmacy education” by Sage Journals.
I even found a database – Janusinfo – which categorizes each medication by their environmental hazard. Here is an example I got from running a report on Clopidogrel:
While changes towards environmental practices might not be easy for some pharmacies, it is necessary to make a difference (no matter how small it looks) and slow down or reverse climate change. But it will work only if all of us are committed to making a change.