Life Sciences & Net Zero: Charting a Sustainable Path

Healthcare is one of the cornerstones of our society. High-quality healthcare is effective, patient-centric and vital for the population's well-being. However, healthcare alone accounts for 5% of global greenhouse gas emissions ^{1, 2} – if this were a country, it would be the 5th largest producer after China, the U.S, India, and Russia ⁶; equivalent to annual global aviation and shipping emissions combined ^{3, 4, 5}.

#advertisement

Healthcare also contributes to a significant proportion of global waste; for example, NHS England generates 156,000 tonnes of waste per year ⁷. This environmental concern extends to the pharmaceutical industry as well. This year, the government established the Pharmaceuticals in the Environment Group (PiE), a cross-government platform created to identify potential pharmaceutical contributors entering the environment and discuss their unintended consequences. It is increasingly apparent that the quality of our health depends on the health of our planet and the ecosystems we live in - patient and planet health are intertwined ^{8, 9, 10}.

Facing the Task Ahead

Clinical trials, a mechanism for introducing new medications and other interventions to the market, are a crucial element of the healthcare value chain. In 2021, there were 350,000 clinical trials registered globally. These accounted for 27.5 million tonnes of CO₂ ¹¹ and significant waste, with up to 50% of clinical supplies never used ^{12, 13}. This highlights the urgent need for environmentally sustainable practices within the industry. Reducing waste and carbon emissions in clinical trials aligns with global sustainability goals and enhances the efficiency and cost-effectiveness of healthcare research.

In 2023 the number of clinical trials has risen to 454,000 and is set to increase ¹⁴, with a predicted compound annual growth rate of 5.8% - doubling in value by 2030 to be worth £61.3 billion ¹⁵. The growth of clinical trials is driven by technological advances, increasing R&D investments and a growing population, coupled with improved identification of infectious and rare diseases. As the market grows, the challenges compound and will lead to an even more significant environmental burden.

We’re at a critical junction: the deterioration of the environment is predicted to have a global cost to patient health of £3.2 billion per year by 2030 ⁸ from direct impacts alone, such as extreme weather events, increased incidence of zoonoses, and changes to weather patterns. This cost not only encompasses the direct healthcare expenses but also accounts for the broader socioeconomic consequences, including loss of productivity, increased healthcare burden, and strain on public health systems. The response to this challenge must be multi-faceted, addressing both the immediate health concerns and the underlying environmental causes to safeguard public health effectively and ensure a sustainable future.

Redefining Clinical Trials for Sustainability

Organisations need to tackle the sustainability impacts of clinical trials through a patient- and planet-centric approach underpinned by effective planning. By embedding circular economy principles and leveraging technological innovation, such as synthetic populations (artificial populations that represent the characteristics and demographics of people living in a defined area) and cloud-based platforms, organisations can improve the efficiency of clinical trials whilst minimising the environmental impact throughout the trials' lifecycle.

Furthermore, using digital models to simulate energy and resource use can help us find ways to cut down on energy and waste. This method also shows us the best times to add remote and decentralised aspects to the trials, making them more efficient.

Adopting a planet- and patient-centric approach involves more than just emissions and waste; it includes people. A recurring challenge for clinical trial sponsors is the inclusion of disease-accurate and diverse demographics; patients don’t all respond similarly, and therapies aren’t always equally effective across diverse populations. Incorporating sustainable principles in trial design can improve patient retention and recruitment by enhancing patient experiences and interactions and offering robust patient support.

Embracing Technological Advancements

Leveraging technology, particularly emerging AI, is crucial for enhancing R&D efficiency in the rapidly expanding sector of clinical trials. The right technology and device strategy can make trials more targeted and accessible. Involving patients and stakeholders from the start, alongside the effective use of digital enablers in true study design and protocol development ensures that trials are representative, efficient, and relevant. This inclusive approach tailors trials to diverse patient needs and characteristics, significantly enhancing their reliability in the real world.

Transitioning to a true digital/electronic data capture systems allows clinical trials to substantially reduce the need for hard copies, thereby minimising waste and the environmental impact of paper production and disposal. Additionally, digital data systems enhance the efficacy of tracking and reporting sustainability metrics. This helps keep organisations on track when adhering to environmental regulations and monitoring their progress toward sustainability goals.

Efforts to reduce the environmental burden of clinical trials will benefit the patient, whilst leading to significant improvements in efficiency, risk reduction, and cost savings and progress the industry along the path to the future benefit of the planet. When underpinned by a robust framework, well-defined metrics, and proven principles, sustainable clinical trial design will offer transparency and direction for efforts to achieve net-zero and broader sustainability ambitions.

Taken together and progressing with a unified effort, these crucial steps can enable sponsors and governing and trade bodies to tackle the diverse and complex issue of sustainability in clinical trials to benefit all involved – the patients, organisations and the planet.

References

M Lenzen et al. The environmental footprint of health care: a global assessment, The Lancet Planetary Health, volume 4, issue 7, e271 – e279, July 2020, https://doi.org/10.1016/S2542-5196(20)30121-2
I Tennison et al. Health care’s response to climate change: a carbon footprint assessment of the NHS England, The Lancet Planetary Health, volume 5, issue 2, e94 – e92, Feb 2021, https://doi.org/10.1016/S2542-5196(20)30271-0
Protecting the planet and its people: healthcare’s climate action roadmap, published online at World Economic Forum, Global Health, July 2021, Protecting planet and people: healthcare's climate roadmap | World Economic Forum (weforum.org) (accessed:14-Nov-2023)
CO2 emissions by sector, published online at OurWorldinData.org, CO₂ emissions by industry, World (ourworldindata.org) (accessed: 14-Nov-2023)
H Ritchie, Cars, planes, trains: where do CO2 emissions from transport come from?, published online at OurWorldinData.org, Cars, planes, trains: where do CO2 emissions from transport come from? - Our World in Data (accessed: 14-Nov-2023)
Thermo Fisher interview: Making clinical trials more sustainable by digitization and decentralization, published online at Outsourcing-pharma.com, March 2023, Thermo Fisher interview: Making clinical trials environmentally friendly (outsourcing-pharma.com) (accessed: 14-Nov-2023)
NHS clinical waste strategy, NHS, publication ref: PR2159, March 2023, NHS England » NHS clinical waste strategy
Climate change and health, published online at World Health Organization, October 2023, Climate change (who.int) (accessed: 14-Nov-2023)
Climate Effects on Health, published online at Centres for disease Control and Prevention (CDC).gov, Climate Effects on Health | CDC (accessed: 14-Nov-2023)
Delivering a ‘Net Zero’ National Health Service, NHS, publication ref: PAR133, July 2022, B1728-delivering-a-net-zero-nhs-july-2022.pdf (england.nhs.uk)
Clinical trials, health, and climate change, published online at Sustainable Healthcare Coalition.org, Clinical Trials | Sustainable Healthcare Coalition (shcoalition.org) (accessed: 14-Nov-2023)
Achieving sustainability through clinical trials innovation, published online at lifesciences.n-side.com, Achieving Sustainability Through Clinical Supply Innovation (n-side.com) (accessed 24-Nov-2023)
Clinical supply chains: How to boost excellence and innovation, McKinsey & Company research article, published online at Mckinsey.com, November 2021, Clinical supply chains: How to boost excellence and innovation | McKinsey (accessed 24-Nov-2023)
Total number of registered clinical studies worldwide since 2000, published online at Statista.com, Total number registered clinical studies worldwide 2000-2023 | Statista (accessed: 14-Nov-2023)
Clinical Trials Market Size, Share & Trends Analysis Report By Phase (Phase I, Phase II, Phase III, Phase IV), By Study Design, By Indication (Pain Management, Oncology, CNS Condition, Diabetes, Obesity), By Region, And Segment Forecasts, 2023 – 2030, Market analysis report published online at Grandviewresearch.com, report ID: GVR-1-68038-975-3, Global Clinical Trials Market Size & Trends Report 2030 (grandviewresearch.com) (accessed: 14-Nov-2023)