Integrating environmental effects in the benefit-risk assessment of therapeutic products: a proposal and example for sustainable health and healthcare

To mitigate healthcare’s unintended effects, environmental risk data such as ecotoxicity and environmental contamination need to be considered by all stakeholders in the healthcare value chain. As decision-makers and educators, healthcare providers are in a unique position to make healthcare deliver...

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Main Authors: Emiliano Giovagnoni, Luisa Mattoli, Andrea Cossu, Vitalia Murgia
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-01-01
Series:Frontiers in Drug Safety and Regulation
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Online Access:https://www.frontiersin.org/articles/10.3389/fdsfr.2024.1519142/full
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author Emiliano Giovagnoni
Luisa Mattoli
Andrea Cossu
Vitalia Murgia
author_facet Emiliano Giovagnoni
Luisa Mattoli
Andrea Cossu
Vitalia Murgia
author_sort Emiliano Giovagnoni
collection DOAJ
description To mitigate healthcare’s unintended effects, environmental risk data such as ecotoxicity and environmental contamination need to be considered by all stakeholders in the healthcare value chain. As decision-makers and educators, healthcare providers are in a unique position to make healthcare delivery more sustainable. However, current benefit-risk assessments of therapeutic products do not systematically include environmental risk data. The purpose of this paper was to review the literature and regulatory context and propose expanding benefit-risk assessments of therapeutic products to include an evidence-based evaluation of environmental impact to inform decision-making. Our findings indicate that environmental risk assessments need to be broadened to include aspects such as excipients, synergistic effects of contaminants, and risks to humans (e.g., drinking water). Concrete proposals to improve current regulatory guidelines for environmental risk assessment already exist. Open access databases on environmental risk of substances used in products for human consumption are available. The European Union Regulation on Medical Devices provides the basis for evidence-based approach to developing sustainable therapeutic products based on natural substances. Based on this, the here promoted decision scheme for healthcare providers (and other stakeholders) involves comparing the clinical safety and efficacy of therapeutic products; comparing environmental impact data; and then deciding. A case example involving the treatment of patients with gastroesophageal reflux and dyspepsia is presented. We provide suggestions for integrating persistence and ecotoxicity data into clinical practice. Expanding the benefit-risk assessment to include data on environmental impact during clinical decision-making is a way to achieve a healthier outcome for all.
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spelling doaj-art-e6d175f81d5846019b66e4ee12673c7b2025-08-20T02:46:40ZengFrontiers Media S.A.Frontiers in Drug Safety and Regulation2674-08692025-01-01410.3389/fdsfr.2024.15191421519142Integrating environmental effects in the benefit-risk assessment of therapeutic products: a proposal and example for sustainable health and healthcareEmiliano Giovagnoni0Luisa Mattoli1Andrea Cossu2Vitalia Murgia3Aboca S.p.A., Loc. Aboca, Sansepolcro, ItalyAboca S.p.A., Loc. Aboca, Sansepolcro, ItalyAboca S.p.A., Loc. Aboca, Sansepolcro, ItalyPediatric Unit, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, ItalyTo mitigate healthcare’s unintended effects, environmental risk data such as ecotoxicity and environmental contamination need to be considered by all stakeholders in the healthcare value chain. As decision-makers and educators, healthcare providers are in a unique position to make healthcare delivery more sustainable. However, current benefit-risk assessments of therapeutic products do not systematically include environmental risk data. The purpose of this paper was to review the literature and regulatory context and propose expanding benefit-risk assessments of therapeutic products to include an evidence-based evaluation of environmental impact to inform decision-making. Our findings indicate that environmental risk assessments need to be broadened to include aspects such as excipients, synergistic effects of contaminants, and risks to humans (e.g., drinking water). Concrete proposals to improve current regulatory guidelines for environmental risk assessment already exist. Open access databases on environmental risk of substances used in products for human consumption are available. The European Union Regulation on Medical Devices provides the basis for evidence-based approach to developing sustainable therapeutic products based on natural substances. Based on this, the here promoted decision scheme for healthcare providers (and other stakeholders) involves comparing the clinical safety and efficacy of therapeutic products; comparing environmental impact data; and then deciding. A case example involving the treatment of patients with gastroesophageal reflux and dyspepsia is presented. We provide suggestions for integrating persistence and ecotoxicity data into clinical practice. Expanding the benefit-risk assessment to include data on environmental impact during clinical decision-making is a way to achieve a healthier outcome for all.https://www.frontiersin.org/articles/10.3389/fdsfr.2024.1519142/fullbenefit-risk assessmentenvironmental riskone healthgreener pharmacybiodegradabilitymedical devices made of substances
spellingShingle Emiliano Giovagnoni
Luisa Mattoli
Andrea Cossu
Vitalia Murgia
Integrating environmental effects in the benefit-risk assessment of therapeutic products: a proposal and example for sustainable health and healthcare
Frontiers in Drug Safety and Regulation
benefit-risk assessment
environmental risk
one health
greener pharmacy
biodegradability
medical devices made of substances
title Integrating environmental effects in the benefit-risk assessment of therapeutic products: a proposal and example for sustainable health and healthcare
title_full Integrating environmental effects in the benefit-risk assessment of therapeutic products: a proposal and example for sustainable health and healthcare
title_fullStr Integrating environmental effects in the benefit-risk assessment of therapeutic products: a proposal and example for sustainable health and healthcare
title_full_unstemmed Integrating environmental effects in the benefit-risk assessment of therapeutic products: a proposal and example for sustainable health and healthcare
title_short Integrating environmental effects in the benefit-risk assessment of therapeutic products: a proposal and example for sustainable health and healthcare
title_sort integrating environmental effects in the benefit risk assessment of therapeutic products a proposal and example for sustainable health and healthcare
topic benefit-risk assessment
environmental risk
one health
greener pharmacy
biodegradability
medical devices made of substances
url https://www.frontiersin.org/articles/10.3389/fdsfr.2024.1519142/full
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