Final report: Let’s decarbonise the healthcare industries

The Shift Project’s Health team is pleased to publish its final reports “Decarbonising the pharmaceutical industries” and “Let’s decarbonise the medical device industries“, in partnership with CNAM, HCAAM, and MGEN. You can discover our work.

Decarbonising the pharmaceutical industries:

• The summary

Let’s decarbonise the medical device industries:

• The summary

For the first time in France, The Shift Project provides a carbon assessment of drugs and medical devices based on physical data, and highlights concrete solutions for the decarbonisation of industries.

In its two reports “Decarbonising the pharmaceutical industries” and “Let’s decarbonise the medical device industries“, the health team of The Shift Project highlights the significant carbon footprint of health industries, with more emissions of 9,1 million tons of CO2 equivalent for medicines consumed in France, and an estimated 7.4 million tons of CO2 equivalent for medical devices.

However, there is a promising potential for decarbonisation by 2050, with a possible reduction of 70% on average for medicines and medical devices. To achieve these goals, it is crucial that decarbonisation covers every link in the health-care value chain, ensuring a complete and effective transition to more sustainable practices.

Emissions are dominated by the production of active ingredients (25%), whose average carbon footprint is estimated at 65 kgCO2 e/kg. This is nearly 105 times more than the carbon intensity of cement. This result is linked to the location of factories producing active ingredients, mainly in Asia where energy mixes are highly carbon-intensive, as well as to the high consumption of electricity and vapors for their production.

30% of emissions come from R&D activities and corporate activities in the pharmaceutical industries. They are notably related to clinical trials, purchases of goods and services, office energy consumption, and the business trips of field staff (including medical conferences).

7% of emissions, or 650,000 tons of CO₂e, come from the use of medical gases. This is equivalent to the emissions generated by more than 75,000 earth revolutions in a thermal car.

Greenhouse gas emissions related to the production of medical devices for French consumers are estimated at 7,4 MtCO₂e, which is equivalent to the annual emissions of the inhabitants of Marseille.
These emissions come largely from the production of raw materials used:

• Plastic first: 200,000 tons of plastic per year, which is equivalent to the annual plastic consumption of 2.8 million French people.
• But also a large amount of steel, aluminum, and electronic components, as well as processing processes, which represent the emissions from production sites of DM industries. 

Transport, packaging production, use, and end-of-life represent relatively lower emissions. These emissions can still be significant for certain products: for example, the electricity consumption of electro-medical equipment, or transport in the case of the use of air freight.

If left unchecked, annual emissions from health-care industries could rise sharply. This increase would be due to the increased consumption of health products caused by the aging of the population, the increase in chronic diseases, the consequences of climate change and the evolution of the proposed products. Among these developments, we note the development of biotherapies and gene therapies, personalized medicine adapted to patient profiles, and the integration of digital technology into medical devices.

According to the National Low-Carbon Strategy (SNBC), the sector must do its part in the fight against climate change and reduce its annual emissions by 2050. It must do so quickly, to limit the accumulation of these emissions between 2025 and 2050. 

In our models for 2050, we do not take into account the evolution of drug consumption between 2025 and 2050. The identified decarbonisation levers enable the medical device industries to reduce by 72% the emissions associated with current consumption of medical devices between 2025 and 2050. All these industries must play their part in this decarbonisation, and each has its own levers: consumables, imaging equipment, technical aids, implants, etc. In the same way, in our central scenario, the potential for decarbonisation of the pharmaceutical industries is 68% between 2025 and 2050.

A decarbonisation that must cover every link in the value chain of health industries.

To be fully effective, decarbonisation must cover every link in the value chain, from raw material production and logistics to energy consumption and end-of-life management. All the actors involved must act quickly and strongly by mobilising all the levers simultaneously. None is optional, all are necessary.

Thus, a decarbonisation of health industries must involve different levers: 

• Levers to decarbonise production processes: for example, electrification of industrial steam generation;
• Levers to decarbonise logistics: for example, reducing the use of air freight for importing imaging equipment;
• Levers during the use of health products, such as giving preference to reusable instruments over their disposable equivalents, or stopping nitrous oxide distribution by hospital networks. Indeed, 90% of nitrous oxide distributed in networks leaks. In other words, we must produce, and therefore release, 10 times more nitrous oxide than what is consumed;
• Levers for decarbonising clinical trials by reducing drug waste and optimising cohorts, thereby reducing visits and travel.

At the same time, we also recommend cross-cutting levers to facilitate decarbonisation: 

• To engage suppliers in developing strategies for reducing their emissions: the decarbonisation of the sector is based above all on supplier mobilisation (chemicals, plastics, metallurgy, textiles, electronics, logistics, sterilisation or mechanics)
• To relocate part of the production of health products to Europe: the production of medicines in France would reduce emissions by 50% compared to production in China, while production in Europe would reduce them by 40%. Relocating production increases the resilience of value chains and the healthcare system as a whole, and increases health sovereignty.
• To define standardised carbon criteria: adopt a standardised carbon footprint calculation method compatible with the plurality of health products and choose an environmental criterion where carbon footprint considerations weigh at least 10% in the overall evaluation score. 
• A consolidation of academic research: some segments are still little studied, and industrial specificities are sometimes omitted. Rigorous life-cycle analyses are essential, otherwise the results may be flawed.
• Involve all industry professionals: To be structuring, the environmental strategy must be brought to the executive committee and fully integrated into the governance of the industry. Moreover, each function (production, purchasing, logistics, R&D, marketing) has a role to play. 

• Mathis Egnell, project engineer and pilot of the Health program at the Shift Project : mathis.egnell@theshiftproject.org
• Baptiste Verneuil, project engineer Medical Device Industries at the Shift Project : baptiste.verneuil@theshiftproject.org
• Robin Henocque, pharmacist in charge of mission Health industries at the Shift Project 
• Margot Aubusson de Cavarlay, Health project manager at the Shift Project
• Mona Poulain, communication manager of the Health program at the Shift Project : mona.poulain@theshiftproject.org 
• Jean-Noël Geist, coordinator of the Health program at the Shift Project : jean-noel.geist@theshiftproject.org
• Thomas Rambaud, project manager Health Industries at the Shift Project, consultant in a health service company and member of the Shifters
• Laurie Marrauld, Health project manager at the Shift Project, lecturer in public health at EHESP and holder of the RESPECT Chair
• David Grimaldi, doctor in intensive cares and cientific advisor Health Industries at the Shift Project