Environmental Impact of Prefilled and Reusable Injectable Systems: A Systematic Review
Author(s)
Matthias Borms, PharmD1, MONICA TELINOIU, MBA, MS2, Haymen Girgis, MD, PhD3, Cecile Frolet, PhD3, Julia D. Lucaci, PharmD, MS4.
1Becton Dickinson, Le Pont de Claix, France, 2Becton Dickinson, FRANKLIN LAKES, NJ, USA, 3Becton Dickinson, le Pont de Claix, France, 4Becton Dickinson, Chicago, IL, USA.
1Becton Dickinson, Le Pont de Claix, France, 2Becton Dickinson, FRANKLIN LAKES, NJ, USA, 3Becton Dickinson, le Pont de Claix, France, 4Becton Dickinson, Chicago, IL, USA.
OBJECTIVES: Interest in understanding the environmental impact of injectable drug-delivery devices, such as prefilled and reusable formats, continues to grow, yet robust evidence is still lacking and reported metrics vary widely. This systematic review consolidates published data on resource use, waste generation, and carbon-dioxide-equivalent (CO2e) emissions to quantify their environmental impact and identify gaps that impede wider adoption and policy alignment.
METHODS: We conducted a systematic literature review (SLR) in June 2024, in accordance with PRISMA 2020 reporting guidelines. Comprehensive searches of PubMed/Medline and Embase combined controlled vocabulary with free-text terms related to environmental impact and sustainability of the use of injectable drug delivery systems. Eligible studies had to quantify at least one environmental endpoint, including drug and device wastage, recycling and reusability, resource use, or CO2e emissions.
RESULTS: A total of fifteen studies met the inclusion criteria, most addressing waste and recycling or reusability. In a 12-hospital cohort study, ready-to-administer prefilled syringes eliminated approximately 140,000 syringes and 5 t of waste each year, reducing wastage by up to 86%. An intensive care unit audit reduced wastage from 31% to 5% and decreased case-level CO₂e by 93%. Modular or reusable injection platforms also decreased device-level global warming potential by 12%. A survey found that although 80% of clinicians endorse recycling, only 28% routinely practice it, revealing operational barriers.
CONCLUSIONS: This review suggests that the use of injectable drug delivery devices, such as prefilled syringes and reusable systems, can reduce the environmental impact by cutting waste and related CO₂e emissions while maintaining medication safety. Wider uptake remains limited due to inconsistent sustainability metrics and the lack of clear operational guidance from health technology assessments, health systems, and regulators.
METHODS: We conducted a systematic literature review (SLR) in June 2024, in accordance with PRISMA 2020 reporting guidelines. Comprehensive searches of PubMed/Medline and Embase combined controlled vocabulary with free-text terms related to environmental impact and sustainability of the use of injectable drug delivery systems. Eligible studies had to quantify at least one environmental endpoint, including drug and device wastage, recycling and reusability, resource use, or CO2e emissions.
RESULTS: A total of fifteen studies met the inclusion criteria, most addressing waste and recycling or reusability. In a 12-hospital cohort study, ready-to-administer prefilled syringes eliminated approximately 140,000 syringes and 5 t of waste each year, reducing wastage by up to 86%. An intensive care unit audit reduced wastage from 31% to 5% and decreased case-level CO₂e by 93%. Modular or reusable injection platforms also decreased device-level global warming potential by 12%. A survey found that although 80% of clinicians endorse recycling, only 28% routinely practice it, revealing operational barriers.
CONCLUSIONS: This review suggests that the use of injectable drug delivery devices, such as prefilled syringes and reusable systems, can reduce the environmental impact by cutting waste and related CO₂e emissions while maintaining medication safety. Wider uptake remains limited due to inconsistent sustainability metrics and the lack of clear operational guidance from health technology assessments, health systems, and regulators.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
MT15
Topic
Health Service Delivery & Process of Care, Medical Technologies, Study Approaches
Disease
No Additional Disease & Conditions/Specialized Treatment Areas