Presentation (CTI)

OBJECTIVES: The healthcare sector is a significant contributor to global greenhouse gas emissions, highlighting the need to incorporate environmental impacts into economic evaluations. As health technology assessments (HTAs) worldwide increasingly consider carbon footprints, efforts are being made to quantify these impacts to enable sustainable decision-making. This targeted review examines methods for integrating carbon footprints and other environmental metrics into economic evaluations of healthcare interventions.
METHODS: A targeted review of peer-reviewed literature published in PubMed was conducted to extract key environmental and economic metrics. The review focused on methodologies such as incremental comparisons, life-cycle frameworks, and scenario analyses for interventions with measurable environmental impacts.
RESULTS: The targeted search identified 1,007 studies, of which 21 were deemed relevant to the review’s objective. Despite the limited literature, several key measures have emerged for incorporating environmental considerations into economic evaluations. These include environmental, health, and economic metrics. Environmental metrics centred on incremental carbon footprint, life-cycle emissions (cradle-to-grave), and scope 1-3 emissions. Growing emphasis is placed on indirect (scope 3) emissions, which are often overlooked in traditional evaluations. Health metrics such as disability-adjusted life years (DALYs) and quality-adjusted life years (QALYs) are used to capture trade-offs between health benefits and environmental harms. The DALY/QALY ratio offers a way to compare health gains with health losses attributable to emissions from healthcare interventions. Economic metrics include social cost of carbon and incremental cost per footprint reduction, alongside cost-offsets and budget impacts associated with new technology adoption. Methodologically, studies commonly employed life-cycle assessments, hybrid economic input-output analyses, and scenario-based sensitivity analyses to account for the complex relationship between environmental impact and economic value.
CONCLUSIONS: Integrating environmental metrics into economic evaluations promotes more sustainable healthcare decision-making. However, the literature remains limited, emphasizing the need for standardized methodologies and greater integration of environmental impacts into routine economic evaluations to foster sustainable healthcare practices.