Presentation (CTI)

OBJECTIVES: Reducing healthcare’s environmental footprint is an emerging priority. This study assesses the ecological impact of subcutaneous (SC) versus oral drug delivery, both administered in ambulatory settings, and includes a sensitivity analysis assuming quarterly oral treatment delivery, reducing logistical and packaging burdens.
METHODS: A one-year model was developed to compare waste production and carbon emissions (CO₂e) for 1,000 patients receiving either monthly SC or oral treatment. The analysis focused on emissions from patient travel to community pharmacies and the manufacturing of auto-injectors, needles, and packaging. Waste included medical disposables and secondary packaging. Input parameters were drawn from manufacturers' environmental reports, institutional databases, and the literature. The model excluded emissions from active pharmaceutical ingredient production.
RESULTS: Annual SC treatment for 1,000 patients generated 1.1 tons of waste and 7 tons of CO₂e. In comparison, monthly oral therapy produced 331 kg of waste and 6.5 tons of CO₂e, representing reductions of 756 kg of waste and 504 kg of CO₂e. A sensitivity analysis assuming quarterly oral dispensation projected further reductions—1 ton of waste avoided and a decrease of 5.4 tons of CO₂e, equivalent to driving 36,000 km by car or 10 round-trip flights between Paris and Rome.
CONCLUSIONS: Oral treatments are associated with lower environmental footprint compared to subcutaneous administration, particularly when dispensed quarterly. From an environmental standpoint, these results contribute highlight the interest in the rational use of oral therapies in long-term management strategies where clinically appropriate, to align therapeutic value with environmental responsibility.