Presentation (CTI)

OBJECTIVES: The healthcare industry has a significant environmental impact, accounting for an estimated 4.4% of total CO2 emissions, with higher figures in high-income countries. Medicinal products and associated transportation are major contributors to the healthcare industry's environmental footprint. However, the extent to which health technology assessment (HTA) bodies consider environmental factors in their evaluations remains unclear. This study aimed to analyze HTA reports from various countries to assess how HTA bodies integrate environmental considerations into their decision-making processes.
METHODS: This analysis builds upon a previous study. An extensive search using 27 relevant keywords (e.g., carbon, climate, CO2, environment, sustainability) was performed to identify HTA reports that addressed environmental considerations. The analysis included on HTAs from eleven countries (Australia, Canada, Denmark, France, Germany, Italy, the Netherlands, Spain, Sweden, United Kingdom, United States) and EUnetHTA published between July 2023 and February 2025.
RESULTS: A total of 2,848 HTAs were screened, with only 19 (0.7%) mentioning environmental considerations. This is an increase compared to the previous study, which identified 14 HTAs (out of 9,493; 0.1%) discussing environmental factors published between July 2018 and June 2023. Most reports mentioning environmental considerations were related to drugs (10), followed by procedures (7), and medical devices (2). Australia had the highest number of reports mentioning environmental considerations (9), followed by Canada (2), France (2), Scotland (2), Spain (1), the Netherlands (1), and the UK (1). Environmental considerations influenced the outcomes of one-third of HTAs (31.5%; 6 out of 19), with the majority (4 out of 6) having a positive impact.
CONCLUSIONS: The limited inclusion of environmental considerations in HTA reports highlights the need for greater integration of sustainability assessments in HTA processes. Incorporating environmental impacts into HTAs can provide a more comprehensive understanding of the overall value of healthcare interventions and support informed decision-making towards more sustainable healthcare practices.