Environmental Impact of Switching from Daily to Weekly Basal Insulin Administration in France

OBJECTIVES: Basal insulins are a cornerstone of diabetes treatment. The treatments currently prescribed in France must be administered once daily (OD) leading to, in addition to the burden for patients, a significant plastic waste and carbon emissions. Future basal insulin treatments may be administered once weekly (OW). The objective is to assess the environmental impact of OW versus OD basal insulin in the treatment of people living with diabetes.

METHODS: A model was developed to compare the plastic and carbon footprint of patients treated either with OD (long-acting insulins) or OW basal insulin administered via a preloaded injection device (pen). Insulin consumption in France was obtained based on the drug prescription and consumption information made available by the national health insurance (Open medic), and the market shares for the different basal insulin were obtained from the Groupement pour l'Elaboration et la Réalisation de Statistiques (GERS). The carbon emissions and plastic consumption attributable to the materials, production, distribution, use and waste were documented by the manufacturer (publicly available).

RESULTS: On average a patient treated with OW basal insulin would use 5 insulin pens per year compared with 22 pens for OD insulins. Taking a sample of 100,000 diabetic patients, a switch from OD to OW basal insulin would therefore amount to a reduction of 37 tons of plastic waste and 1,7 kilotons of carbon emissions per year. Considering today’s plastic and carbon taxes, it would economically translate into a reduction of 39 K€ and 25 K€ respectively for the compensation to the environmental impact.

CONCLUSIONS: Results suggest that transitioning from OD to OW insulin administration could substantially reduce plastic waste and carbon emissions and translate into considerable cost savings. OW basal insulin and the development of pen recycling programmes represent options to mitigate the environmental impact while offering effective treatment for people living with diabetes.