INCORPORATING THE EFFECTS OF PHARMACEUTICAL WATER POLLUTION INTO A HEALTH TECHNOLOGY ASSESSMENT: AN INTERREG-NWE PREWAPHARM (PREVENTION OF WATER POLLUTION BY PHARMACEUTICALS) PROJECT
Author(s)
Jesse Tuinhof, MSc, Kimberly Kleefman, MSc, Katja Taxis, MSc, PhD, Talitha Feenstra, MSc, PhD.
Groningen Research Institute of Pharmacy (GRIP), University of Groningen, Groningen, Netherlands.
Groningen Research Institute of Pharmacy (GRIP), University of Groningen, Groningen, Netherlands.
OBJECTIVES: To develop a framework for a health technology assessment (HTA) that incorporates pharmaceutical water pollution (PWP) in the evaluation of pharmacy-orientated mitigation strategies.
METHODS: Key publications and reports on incorporating environmental impact into HTA, ecotoxicity, environmental impact assessment and wastewater treatment were reviewed to extract or develop methods estimating PWP. Each method was evaluated on data requirements, international transferability, the ability to be converted into monetary or health units and evaluated regarding applicability to different mitigation strategies performed in a community pharmacy (e.g. takeback programs). Furthermore, a few example interventions were discussed during an international meeting with stakeholders. Finally, a decision tree was created to guide method selection.
RESULTS: Identified methods to measure the impact of PWP were based on: (1) emissions reduced, (2) risk categories, (3) partial lifecycle assessment (LCA) and (4) direct monetary valuation of the interventions. Methods based on partial LCA and direct valuation can directly be integrated into HTA, since they result in monetary values and/or QALYs. This was impossible for methods based on emission reduction and risk categories, results of those methods need to be presented and weighed alongside the HTA results. Methods also vary regarding suitability for interventions targeting a wide range of pharmaceuticals. Depending on the mitigation strategy and the applied use-related criteria suitable methods can be selected, guided by the decision tree.
CONCLUSIONS: This framework was developed to evaluate mitigation strategies focused on water pollution, but the underlying methods can be generalized to be incorporated alongside additional environmental aspects into HTA. *This project was funded by the EU under grant no. NWE0400548. Views and opinions expressed are those of the author(s) only. Neither the European Union nor the granting authority can be held responsible for them
METHODS: Key publications and reports on incorporating environmental impact into HTA, ecotoxicity, environmental impact assessment and wastewater treatment were reviewed to extract or develop methods estimating PWP. Each method was evaluated on data requirements, international transferability, the ability to be converted into monetary or health units and evaluated regarding applicability to different mitigation strategies performed in a community pharmacy (e.g. takeback programs). Furthermore, a few example interventions were discussed during an international meeting with stakeholders. Finally, a decision tree was created to guide method selection.
RESULTS: Identified methods to measure the impact of PWP were based on: (1) emissions reduced, (2) risk categories, (3) partial lifecycle assessment (LCA) and (4) direct monetary valuation of the interventions. Methods based on partial LCA and direct valuation can directly be integrated into HTA, since they result in monetary values and/or QALYs. This was impossible for methods based on emission reduction and risk categories, results of those methods need to be presented and weighed alongside the HTA results. Methods also vary regarding suitability for interventions targeting a wide range of pharmaceuticals. Depending on the mitigation strategy and the applied use-related criteria suitable methods can be selected, guided by the decision tree.
CONCLUSIONS: This framework was developed to evaluate mitigation strategies focused on water pollution, but the underlying methods can be generalized to be incorporated alongside additional environmental aspects into HTA. *This project was funded by the EU under grant no. NWE0400548. Views and opinions expressed are those of the author(s) only. Neither the European Union nor the granting authority can be held responsible for them
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
HTA389
Topic
Economic Evaluation, Health Technology Assessment
Topic Subcategory
Value Frameworks & Dossier Format
Disease
No Additional Disease & Conditions/Specialized Treatment Areas