OBJECTIVES: Climate breakdown is affecting human health globally. The National Health Service (NHS) generates 26 million tonnes of CO₂^e per annum equivalent to the size of Croatia’s annual emissions. Healthcare suppliers possess a sizeable opportunity to support health technology environmental sustainability (HTES) underpinned by leaner pathways and resource optimization. HTA is developing approaches to include environmental sustainability (ES). Reporting a broad range of environmental outcomes is important, but there is a lack of published guidance. This study aims to develop recommendations for decision makers on how broader environmental criteria should be included in HTA, based on the technical validation of an environmental model of Aurora EV-ICD by Medtronic.

METHODS: The Medtronic environmental model estimates the impact of the device on CO₂^e, water usage and waste volumes over a 10-year time horizon. A multi-step process was used to internally validate the model, using a specifically designed checklist for HTES models being reported as an information conduit. Recommendations were provided to support appropriate reporting of the data to the NHS.

RESULTS: The model structure was deemed appropriate and suitable for submission to the NHS. Recommendations for reporting ES to the NHS include: 1) using and referencing multiple environmental management guidelines for reporting CO₂^e to ensure transparency and reproducibility; 2) applying the same principles to quantify other environmental outcomes that will enable a more holistic evaluation of unintended consequences, including human health impact, resource use and biodiversity loss; 3) using life cycle assessment software (such as OpenLCA) to overcome data challenges and to facilitate reporting appropriate and comprehensive environmental endpoint categories.

CONCLUSIONS: This multi-perspective collaboration between industry and researchers supports ES in HTA framework development. These recommendations can be used by decision makers to aid the inclusion of environmental models that supports reporting a broader range of environmental outcomes over a long-term time horizon.