- 2 years ago
22 July 2024
Policy levers such as regulatory reform and health technology assessment (HTA) have a role to play in reducing the impact of medicines and medical technologies on global warming but the greatest impact on the health of the planet will be through keeping people healthy, says David Pullar, Director of Communications, Government Affairs and Market Access at GSK Australia.
As a multinational corporation strongly committed to reducing its impact on climate change, GSK has set ambitious targets to reduce its carbon emissions by 80 per cent by 2030 and 90 per cent by 2045. To achieve this, all of its employees are engaged in reducing the company’s environmental impact.
“GSK is taking this very seriously,” says Pullar. “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.”
GSK’s Classic and Established Products Global Commercialisation Lead, Tony Keogh, will tomorrow (Tuesday) give the keynote address at the ‘Shaping the future of environmental sustainability and healthcare access‘ summit being held in Sydney while GSK Global Medical Lead Max Plank is also speaking.
The two global executives will stress the importance GSK places on embedding good environmental practices across the business, whether that be in commercial, market access or medical affairs, even extending its remit to clinicians and patients who engage with its products.
“If you look at sustainability holistically, preventing disease and properly controlling disease in a proactive way is one of the most impactful things we can do,” says Pullar. “As the climate changes, there will be an increasing need to intervene in health and protect people from those impacts, which means investing in keeping people healthy.
“If you’re keeping people out of intensive or acute care, you’re immediately having a positive impact. As a company, we do a lot to prevent disease, prevent severity of disease, and to make sure disease is well managed.
“That’s something we at GSK feel strongly about, but it does not excuse us from looking at the impact of our individual technologies. As a company, we have a responsibility to innovate so our products and supply chains are less impactful on the environment.”
Environmental sustainability and HTA
When it comes to individual products, metered-dose respiratory inhalers are considered a leading cause of global warming due to some gases used, yet it is estimated these products make up just 0.5 per cent of the total emissions produced by Australia’s health system and just 0.03 per cent of Australia’s total emissions.
He says in moving to ban some gases before a replacement was available, Europe could negatively impact patient health – an example of the danger of driving change before its full impact is understood and, given the small impact of metered dose inhalers on total emissions, the impact of products in other classes is likely to be very small.
He said there is a risk companies could be asked to produce excessive data or make expensive changes to enable product comparisons in HTA based on sustainability requirements when it may not improve decision making, and their efforts could be better spent elsewhere.
Yet Pullar says sustainability does have a place in HTA, noting if it is excluded entirely, some innovations may not be recognised.
“There are many changes we at GSK could make to our processes and products to reduce their climate impact, but they come at a cost,” he says.
“If companies are to be incentivised to innovate and come up with solutions that reduce climate impact, ultimately that needs to be reflected in the price.
“There’s value in HTA looking at important differences between products, but not in areas where the environmental impact might be negligible or uncertain, or where preferring one product over another might actually have perverse outcomes.”
Need for an international perspective
Regulatory reform is another area where governments are looking to deliver more environmentally sustainable outcomes, yet Pullar says again caution needs to be used as regulation can be “a blunt instrument” that leads to unintended consequences.
“If the regulation involves banning a product patients depend on, that’s an unintended consequence,” he says. “What we want to do is improve the environment while still maximising patient health.
“One of the big challenges with climate policy at government level is that governments sign up to big international protocols then ask how they are going to achieve those targets and what policies they have to put in place.
“Some good things about the HTA Review Options Paper and the Government’s Health and Climate Strategy is that they look to international collaboration, because Australia can’t solve this on our own.”
As a leading manufacturer of respiratory inhalers, GSK does not shy away from the impact inhaler gases have on the environment and is looking at alternatives, but Pullar notes they are expensive. If regulators require new clinical trials, costs could rise even further.
“It’s not just industry coming to government and saying, can you pay for this?” says Pullar. “A lot of discussion needs to be about whether we are meeting patient needs and clinician desires. Are we solving a problem or creating a new problem?”
These are just some of the dilemmas GSK is grappling with, but the company’s commitment to addressing such issues is commendable.
“We recognise we have a responsibility in Australia and around the world, from the point where we develop a medicine to when it is disposed of,” says Pullar. “There are no easy answers, but we consider it part of our responsibility to patients and to the planet to play our part.”
GSK is proudly sponsoring the Sustainability Summit on 23 July as part of its ongoing commitment to supporting open and transparent stakeholder discussions that deliver positive outcomes for both people and the planet.
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