- 2 years ago
19 March 2025
The connection between a healthy environment and a healthy population has been emphasised in a number of 2025-26 pre-budget submissions but a whitepaper just released has urged caution in the push to include penalties for medicines found to not comply with environmental factors through regulatory and health technology assessment (HTA) processes.
The ‘Environmental Sustainability and Healthcare Access’ whitepaper was released following the ‘Shaping the Future’ summit hosted by MedNews, HTAnalysts and Humanise Health last year.
The whitepaper reflects the summit’s view that while all stakeholders in the health sector including patients, industry leaders, academics and policymakers want a healthier system and sustainability is an imperative, adding complexity to an already overly complex regulatory and reimbursement system would likely slow down the move to sustainability rather than speed it up.
“HTA is already a complex and time-intensive process with timelines often exceeding a year in many jurisdictions,” HTAnalysts Chief Vision Officer and summit organiser, Associate Professor Colman Taylor said.
“While environmental impact is undeniably important, introducing additional elements into the assessment framework must be approached with caution.
“The focus should remain on balancing patient outcomes with broader considerations of value, ensuring that new medicines are evaluated efficiently without compromising access for those in need.”
The proportion of Australia’s carbon footprint stemming from healthcare is estimated at seven per cent, with pharmaceuticals responsible for less than a fifth of this, meaning it accounts for less than two per cent of Australia’s total carbon emissions. Hospitals are responsible for almost half.
While the Federal Government included decarbonisation of supply chains in its National Health and Climate Change Strategy and the HTA Review recommends incorporating sustainability in HTA, independent experts including HTA Implementation Advisory Group chair Professor Andrew Wilson have said HTA is “not the sweet spot” for considering sustainability issues, although Professor Wilson believes it should be part of the procurement decision-making process.
The Australian Government is working with the UK and US to develop ‘green procurement standards’ for medicines, targeting the sector in its move to hit Labor’s decarbonisation targets despite the sector impacting a tiny fraction of Australia’s CO2 emissions.
Patients emphasised the need to balance environmental objectives with the need to maintain quality patient care at the summit but academics supported the Government’s position, some developing a framework that would enable the inclusion of sustainability factors in HTA.
Some companies, like GSK, are focusing on the full lifecycle of their products to minimise waste and emissions while incorporating sustainability into HTA. For example, GSK is transitioning from high-emission metered dose asthma inhalers to more environmentally friendly, dry powder inhalers, the company’s Global Commercialisation Lead for Established Products, Tony Keogh, telling the Sydney Summit GSK had an ambitious plan to achieve net-zero greenhouse gas emissions across its value chain by 2045.
“GSK is taking this very seriously,” GSK Australia Director of Communications, Government Affairs and Market Access, David Pullar said. “We recognise a lot of our emissions are in areas like energy use, supply chain and manufacturing, but a large amount of our emissions comes from use of some of our products, so we are looking at our product portfolio and our pipeline to make sure we hit our targets.”
Pre-budget submissions take heat off medicines
While the Federal Government has continued its push to reduce CO2 emissions in all aspects of the supply economy, healthcare organisations and alliances that submitted 2025-26 pre-budget submissions all failed to even mention medicines, although some did support the Government’s National Health and Climate Strategy.
Doctors for the Environment Australia, Healthy Futures, Climate and Health Alliance (CAHA), and Environmental Health Australia (EHA) put in pre-budget submissions calling on the Federal Government to prioritise a healthier Australia.
Doctors for the Environment put forward four recommendations including $30 million over three years to fund implementation of the National Health and Climate Strategy and support “the leadership, engagement and coordination functions of the National Health, Sustainability and Climate Unit, in recognition that climate change is the greatest public health problem facing humanity”.
Given the unit’s move to decarbonise pharmaceuticals through procurement decisions, this effectively puts the group in line with the Government’s position despite Doctors for the Environment having a greater focus on hospitals than medicines.
Doctors for the Environment is a member of Healthy Futures, which also has the support of seven teal and independent MPs. Healthy Futures calls on the Federal Government “to fund the feasibility studies for the All-Electric Hospital Retrofit Program in the 2025/26 budget” while CAHA, another alliance of healthcare organisations, calls for $50 million in funding, again targeting hospitals and training rather than medicines.
EHA’s submission focused on “driving economic growth through preventative health”, its ask for $234.3 million over four years looking at capacity building and funding more Environmental Health Officers.
Nine months on from the summit, little has been done to put sustainability into HTA and procurement, although pharmaceutical and medtech companies such as GSK, Moderna and Medtronic are setting their own goals when it comes to ensuring their products are more environmentally sustainable.
“While immediate implementation of carbon footprint information in HTA is feasible, more complex methods require further development,” the whitepaper states.
“Stakeholders are working on integrating these considerations into decision-making processes, with an emphasis on balancing environmental and health impacts. It is believed that if two products have the same clinical effectiveness, measuring their carbon footprints can make the product with a lower carbon footprint more attractive to consumers, even if it’s priced higher than the alternative.”
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