Pharmacists from all practice settings can identify opportunities to create a more sustainable workplace. 

Medicines make up 19% of the Australian health system’s carbon footprint,¹ with embedded emissions found in the manufacture, distribution, consumption and disposal of medicines.²

Optimising medicines in all settings is not only good clinical practice, it also reduces emissions. Pharmacists should encourage and engage in low-carbon prescribing, which entails using the lowest appropriate and effective dose for the shortest duration, opting for medicines that have the smallest carbon footprint and suggesting non-pharmacological therapies where appropriate, such as physiotherapy.

There are various ways pharmacists can help to reduce supply chain emissions.

These include:

• Electric vehicles could be used for the transportation and home delivery of medicines TO patients and residential aged care facilities.³
• Emissions can be reduced in medicines disposal, including separating packaging and contaminated waste from medicines in Returned Unwanted Medicines (RUM) bins. Non-contaminated packaging can be recycled or composted, both reducing waste and RUM incineration volume  –  and ergo carbon emissions.¹

For consultant, general practice and on-site aged care pharmacists, medicines reconciliation and reducing polypharmacy by deprescribing can help to curtail unnecessary prescribing as well as improve quality of life for patients.

Engaging in shared decision-making when establishing treatment goals also provides the opportunity to avoid unnecessary medicines-based solutions. While informing patients about the benefits and risks of each treatment option, pharmacists could include information about the environmental impact to ensure patients fully understand what each alternative entails.

Pharmacists should also encourage self-management to reduce the environmental impact of medicines.

Box 1 – Grace Wong’s top tips

Making sustainable changes

Pharmacists can generate awareness and advocate for change in a variety of ways during everyday operations.

Energy-efficient refrigeration that uses low global-warming potential refrigerants, such as natural refrigerants,⁴ could be an option for pharmacies.

Cutting down on energy used in heating and cooling, one of the biggest emitters of greenhouse gasses,⁵ could also be a long-term investment that reduces both overhead costs and carbon footprint. For example, window tinting is a non-invasive strategy to keep workplaces cool, leading to less air-conditioning use.⁶ Insulating a pharmacy ceiling can also help keep it warm in winter.⁷

Pharmacist behaviour can also help reduce carbon emissions. With light vehicles accounting for approximately 11% of Australia’s greenhouse gas emissions,⁸ pharmacists could opt to walk, cycle, take public transport or carpool to work instead of driving. This can be facilitated by businesses and organisations by way of incentives for alternative modes of travel.⁹

To understand how environmental sustainability in pharmacy works in practice, AP spoke to two pharmacists about embedding green initiatives in their workplaces.

Case 1

Michelle Lynch FPS Chief Operating Officer, Ramsay Pharmacy Group, Melbourne, Victoria 

Environmental and sustainability considerations should be central to business decision-making, and pharmacy is no exception.

Our company developed a ‘Ramsay Cares’ program, which defines our approach to sustainability with three key pillars: healthier people, stronger communities and a thriving planet.

One of our most wide-reaching initiatives from a medication lens was to cut down on the high volume of bubble wrap, ice packs and plastics used to keep chemotherapy drugs safe and at the right temperature.

The pharmacy cancer care team approached our compounding partner Baxter Healthcare to collaborate and find a more sustainable solution. This led to the development of an environmentally responsible solution for medicines – WOOLPACK – packaging made from 100% sheep’s waste wool. The initiative has provided a sustainable, recyclable and viable solution resulting in a significant reduction in the excessive plastic used to deliver chemotherapy.

What’s next? We are seeking ways of recycling empty medicine blister packs and reducing single-use plastics where possible. We’re also focused on water efficiency measures and introducing more renewable energy in our pharmacies. To further reduce our carbon footprint, we’re committed to identifying medicines that contribute to greenhouse gas emissions and finding potential alternatives.

Case 2

Grace Wong Senior Pharmacist, Western Health, Melbourne Victoria 

Working in India at the start of my career, I had first-hand experience of the environmental and human health consequences of pharmaceutical pollution. As medicines are central to our core business, I was keen to learn how I as an individual pharmacist in a hospital pharmacy department could minimise the impact of our work on the environment.

As the department’s first nominated ‘Green Champion’, I learnt about human- centred design principles and applied this technique to elicit ideas from my colleagues. This commitment was formalised as our department’s first Environmental Sustainability Action Plan, a senior management-endorsed document of 25 practical actions for the following 5 years, which was part of the hospital network’s environmental management roadmap.

After a rubbish bin audit found our department produced 100,000 kilograms of waste annually, the equivalent of 55 adult rhinoceroses, I launched a ‘green rhinos’ education campaign.

This led to the development of waste-reduction strategies, including using recycled paper in our printers and finding a local recycler to dispose of our polystyrene.

In the end, the initial 25 actions grew to more than 50, as colleagues identified further ideas to trial and momentum and enthusiasm grew.

Initiatives included adding specific environmental criteria into supplier contracts, creating soft plastics and co-mingled recycling streams, fridge temperature monitoring changes, plumbed Zip tap drinking water, and reducing disposable kitchenware and coffee cups.

I was heartened to see colleagues who were initially reluctant to take part transform into leaders of new initiatives who are guiding others.

About the same time, I founded Pharmacists for the Environment Australia as a way to reach pharmacists beyond my workplace. Supporting pharmacists, consumers and other healthcare professionals to develop sustainable practices is key to driving meaningful change.

References

1. Malik A, Lenzen M, McAlister S, et al. The carbon footprint of Australian health care. Lancet Planetary Health 2018;2(1)E27–35. At: www.thelancet.com/journals/lanplh/article/PIIS2542-51961730180-8/fulltext
2. Singleton JA, Nissen LM, Barter N, et al. The global public health issue of pharmaceutical waste: what role for pharmacists? Griffith University 2014. At: https://research-repository.griffith.edu.au/rest/bitstreams/0c6943aa-20da-51a3-b77e-cb7d0dd2afce/retrieve
3. Royal Pharmaceutical Society: Climate Change Charter Actions. At: www.rpharms.com/recognition/all-our-campaigns/policy-a-z/sustainability-policy/climate-change-charter/climate-actions
4. Europe Commission: Climate-friendly alternatives to HFCs. At: https://climate.ec.europa.eu/eu-action/fluorinated-greenhouse-gases/climate-friendly-alternatives-hfcs_en
5. United States Environmental Protection Agency: Sources of Greenhouse Gas Emissions. At: www.epa.gov/ghgemissions/sources-greenhouse-gas-emissions
6. Wheeler VM, Kim J, Daligault T, et al. Photovoltaic windows cut energy use and CO2emissions by 40% in highly glazed buildings. One Earth 2022. At: www.sciencedirect.com/science/article/pii/S2590332222005401
7. Department of energy. Where to Insulate in a Home. At: www.energy.gov/energysaver/where-insulate-home
8. Green Vehicle Guide. Vehicle emissions. At: www.greenvehicleguide.gov.au/pages/UnderstandingEmissions/VehicleEmissions
9. Climate Council. Transport emissions: driving down car pollution in cities. 2017: At: www.climatecouncil.org.au/wp-content/uploads/2017/09/FactSheet-Transport.pdf