As part of this year’s **Green University Day**, I had the opportunity to speak on an increasingly interesting topic: the intersection of pharmacotherapy and environmental sustainability. While much attention has been given to healthcare’s carbon footprint, there are broader—and in many cases, more urgent—ecological issues linked to how we design, prescribe, and dispose of medicines.
Highlights:
✔ Lifecycle Thinking: Environmental impact should be considered from drug development to disposal—not just during patient use.
✔ Eco-Design: Encouraging the use of **biodegradable APIs** and green chemistry in pharmaceutical manufacturing.
✔ Responsible Prescribing: Avoiding unnecessary prescriptions, especially antibiotics, and supporting deprescribing when appropriate.
✔ Transparent Data: Mandating environmental risk disclosures for all medicines and making this information publicly available.
✔ Safe Disposal: Strengthening medicine return programs and public awareness to prevent environmental contamination.
✔ Cross-Sector Collaboration: Sustainability in healthcare requires cooperation between regulators, industry, academia, and prescribers.
Tools supporting more environmental-responsible prescribing:
🔹New EU Standards: The European Medicines Agency (EMA) updated its “Environmental Risk Assessment (ERA)” guidelines in September 2024, introducing a more rigorous framework for evaluating a drug’s environmental footprint during market authorization.
🔹Sweden’s “Pharmaceuticals and Environment” database (Janusinfo) ranks over 850 active pharmaceutical ingredients (APIs) by environmental risk—helping inform safer prescribing choices.
Every prescription we write carries an environmental footprint as well. As healthcare professionals, we are uniquely positioned to select the most appropriate pharmacotherapy by adhering to clinical guidelines and the Summary of Product Characteristics of the medicines—while also looking beyond and consider the broader ecological impact of our choices.
Renata Papp MD PhD