HEALTHCARE & SUS TAINABI LT Y


Creating hybrid designs Though the discussion makes it clear that efforts are being made in the healthcare industry to reduce environmental impact, it is likely that most devices – especially parenteral or other invasive products – will continue to have a disposable component in the near future. Manufacturers are bound to meet regulatory requirements, and address safety and hygiene concerns, if they wish to get their products to market. Apart from implementing some of the measures outlined here, such as improving manufacturing efficiency or recycling materials, device designers may find it more feasible to develop hybrid devices that integrate a disposable and reusable component. This is a particularly valuable strategy for digitally connected drug delivery devices. Clearly, it is not environmentally or financially viable to produce disposable devices with electronic elements. Yet increased digitalisation has enormous potential to aid patient self-administration, strengthen therapy adherence, and provide both clinicians and payors with valuable information. Among its many benefits, remote patient monitoring can reduce some of the burden on overstretched healthcare services, especially at this time. Using hybrid design, a connected drug delivery device such as an autoinjector would have two components: the embedded electronics can sit in a reusable connected unit, and the traditional drug delivery device which fits inside the unit can be discarded and replaced after each use.


Purchasing power


The NHS has already made some headway in improving its carbon footprint. In fact, between 2007 and 2017, the NHS reduced its footprint by 18.5% despite increasing clinical activity by 27.5%.16


The


organisation’s Sustainable Development Unit is one of the few dedicated units of its kind among health services around the world. The NHS can also leverage its purchasing power to encourage suppliers to improve their sustainability credentials, as about 60% of the health service’s substantial carbon footprint can be attributed to the procurement of goods and services.17


There


are initiatives already in place to address this, such as Procuring for Carbon Reduction (P4CR),18


which assesses the whole


environmental, social and ethical impact of procured products or services. Such initiatives certainly provide an impetus for medical device firms to prioritise the environment and publicly share their efforts. These firms are gaining a competitive advantage in an increasingly environmentally conscious world. However, there is huge scope for improvement, and the pandemic may spark much-needed activity and


APRIL 2021


innovation in this field, especially as we test the capacity of the global cold chain to rapidly roll out vaccines. Interesting solutions for a more sustainable cold chain are already being explored in developing countries.19 As we continue to cope with COVID-19 and its wider effects, we must not lose sight of the issue of sustainability. While preventing the spread of infection must remain a priority, neglecting the climate emergency for too long would be immensely damaging to our planet in the long-term. CSJ


References 1 NHS, Delivering a ‘Net Zero’ National Health Service, 1 October 2020 https://www.england.nhs.uk/ greenernhs/wp-content/uploads/sites/51/2020/10/ delivering-a-net-zero-national-health-service.pdf


2 NHS Providers, Not so fantastic plastic, 12 October 2019 https://nhsproviders.org/news-blogs/blogs/ not-so-fantastic-plastic


3 The Conversation, Healthcare is still hooked on single-use plastic PPE, but there are more sustainable options, 6 August 2020 https:// theconversation.com/healthcare-is-still-hooked- on-single-use-plastic-ppe-but-there-are-more- sustainable-options-143940


4 Directive 2000/76/EC of the European Parliament and of the Council of 4 December 2000 on the incineration of waste


5 Owen Mumford Pharmaceutical Services, Sustaining the Pace: Three perspectives on how sustainability is being achieved in the medical device market, August 2020


6 World Health Organization, Healthcare-associated infections FACT SHEET, 10 December 2010 https:// www.who.int/gpsc/country_work/gpsc_ccisc_fact_ sheet_en.pdf


7 US Food & Drug Administration, Ethylene Oxide Sterilization for Medical Device 24 September 2020 https://www.fda.gov/medical-devices/general- hospital-devices-and-supplies/ethylene-oxide- sterilization-medical-devices


8 Centers for Disease Control and Prevention, Reuse of Single-Use Medical Devices, Guideline for Disinfection and Sterilization in Healthcare Facilities (2008), 18 September 2016 https://www.cdc.gov/ infectioncontrol/guidelines/disinfection/reuse-of- devices.html


9 Medicine and Healthcare products Regulatory Agency, Single-use medical devices: implications and consequences of reuse, October 2019 https:// assets.publishing.service.gov.uk/government/ uploads/system/uploads/attachment_data/ file/842614/Single-use_medical_devices_v2.3_ Oct-19.pdf


10 Regulatory Affairs Professionals Society (RAPS), Industry Criticizes EC’s Specifications for Reprocessing Single-use Devices under EU MDR, 21 August 2019 https://www.raps.org/news-and- articles/news-articles/2019/8/industry-criticizes- ecs-specifications-for-reproc


11 European Commission, Health institutions reprocessing single-use devices https://ec.europa. eu/health/md_newregulations/getting_ready/ health_institutions_reprocessing_single_use_en


About the Author


George I’ons is currently the head of product strategy and insight at Owen Mumford Pharmaceutical Services having worked for the former OEM and now Pharmaceutical Services division of the organisation since 2006. His current focus is on deciphering the rapidly changing pharmaceutical and biotech sectors in relation to their needs for combination products. In his previous roles in business development, he worked closely alongside R&D to develop devices for a variety of global pharmaceutical and diagnostic clients. Prior to Owen Mumford, George worked for Abbott in EMEA marketing roles in Germany, focusing on their diabetes business.


WWW.CLINICALSERVICESJOURNAL.COM l 39


12 PVCMed Alliance, Accessed: 04 January 2021 https://pvcmed.org/


13 PVCMed Alliance, PVC waste management, Accessed: 04 January 2021 https://pvcmed.org/ healthcare/pvc-waste-management/


14 European Commission, A circular economy for plastics, January 2019 https://www.hbm4eu.eu/ wp-content/uploads/2019/03/2019_RI_Report_A- circular-economy-for-plastics.pdf


15 Team Consulting, Sustainability in the medical devices sector, 2020 https://www.team-consulting. com/insights/sustainability-in-the-medical- devices-sector-what-does-it-mean/


16 BMJ 2019;366:l4930 https://www.bmj.com/ content/366/bmj.l4930


17 The BMJ opinion, The plastic pandemic: could the environmental impact of the NHS response to covid-19 be reduced?, 8 December 2020 https:// blogs.bmj.com/bmj/2020/12/08/the-plastic- pandemic-could-the-environmental-impact-of-the- nhs-response-to-covid-19-be-reduced/


18 NHS Sustainable Development Unit, Procurement https://www.sduhealth.org.uk/areas-of-focus/ commissioning-and-procurement/procurement.aspx


19 Modern Diplomacy, COVID-19 vaccine could revolutionize cold storage around the world, 9 December 2020 https://moderndiplomacy. eu/2020/12/09/covid-19-vaccine-could- revolutionize-cold-storage-around-the-world/


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