From a Pill to the Planet: Addressing Healthcare Sustainability through Pharmacoepidemiologic Research

Background: Climate change is “the single biggest health threat facing humanity” (WHO). Ironically, healthcare is responsible for 5-10% of national carbon emissions; prescriptions drugs account for 13% of healthcare emissions. Drug utilization is far from sustainable today. Issues range from overuse and stockpiling to inappropriate waste management. Traces of medicines are found in water from sewage treatment plants and rivers across all continents. Despite the growing awareness, our understanding of pharmaceutical pollution and its implications remains incomplete.

Drug utilization research (DUR) have assessed overuse and inappropriate use of medicines but there is no standards on how to assess utilization patterns in relation to climate impacts. Little is known in patient behaviors such as stockpiling and inappropriate waste management. There is also an emergent need to understand the impact of pharmaceuticals on our ecosystems and health to facilitate sustainable healthcare practices.

Pharmacoepidemiologists are already equipped to address many of these issues. The Environmental Pharmacoepidemiology (EnvPE) SIG contributes to research addressing the intersection among medical products, environmental factors and impacts. We propose this workshop in response to the complex challenges posed by pharmaceuticals in the environment as a critical step towards advancing the field of EnvPE.

Objectives: To discuss how pharmacoepidemiologists can contribute to reducing the environmental and health burdens from pharmaceuticals.

Description: We will bring together expertise from/outside of ISPE, solicit ideas, and create opportunities for collaboration. The workshop will focus on research methods and begin with an overview of current approaches to studying the use, disposal, and environmental and health impact of medicines and include overview of data sources/methods. Subsequently, participants will break into working groups (WGs); 1. DUR using large databases; 2. Consumer perspective/behaviour research to assess use and disposal of pharmaceuticals; and 3. Evn hazard research to assess the environmental and health burden of pharmaceutical wastes.
Overview (30 min):
• DUR
• Consumer/patient behaviour/perspective research
• Environmental risk research
WG Discussion (45 min): Each WG will engage in discussions and exercises to address critical questions: What methodological tools and data sources are available to support these efforts? What to advance the field and promote collaborations?
• WG1: DUR (led by BW, EP)
• WG2: Consumer perspective research (led by KT, SS)
• WG3: Env hazard research (led by JV, GM)
Summary and conclusions (15 min): Each group will share as summary of the WG discussion and discuss the next steps or follow-up plans.