OBJECTIVES: The health and life sciences industry has impact on the global environment and climate change. Many stakeholders perceive environmental aspects as important. However, the extent to which Health Technology Assessment (HTA) bodies are looking at sustainability criteria when evaluating new technologies is unclear. This study aimed to examine to what extent environmental factors are considered and whether they have an impact on HTA decisions.

METHODS: An extensive search was conducted using relevant keywords (ecology, ecologic, ecological, sustainability, sustainable, wastage, litter, environment, environmental, pollution) to identify HTA records that mentioned environmental considerations. The analysis focused on HTAs from ten countries (Canada, US, UK, France, Germany, Italy, Spain, Sweden, Denmark, Australia) and EUnetHTA published between July 2018 and June 2023 to determine the extent to which environmental considerations have been included. Additionally, HTA policies and methodology guidelines were reviewed.

RESULTS: We identified 11 HTAs (1 from the US, 4 from Australia, 2 from the UK, 1 from France, 3 from Italy) that mentioned environmental evidence. These HTAs assessed medical devices, procedures, or pharmaceutical products administered using syringes or inhalators. The most relevant considerations cited were packaging waste, environmental contamination, and greenhouse gas emissions. In the review of HTA policies and methodology guidelines, we found five relevant publications (from EUnetHTA, TLV, Medicinrådet, CADTH, and NICE) that mentioned environmental aspects. TLV proposed an environmental premium aiming to promote environmentally sustainable drug production and minimize the release of drug residues. NICE highlighted the growing importance of environmental sustainability and is actively working on including environmental aspects in their processes.

CONCLUSIONS: The current importance of environmental evidence for HTA agencies is low and is expected to gradually increase. While some HTA bodies are beginning to include environmental aspects in their methodologies, they are primarily focused on medical devices or pharmaceutical products administered using inhalators.