March 4, 2010 by David Taylor
This meeting, which attracted around 40 delegates from academia, industry and regulators, was a mixture of formal input and workshop sessions designed to clarify the meaning of the term “Sustainable Pharmacy” and how progress could be made to achieve it.
Two plenary papers, one from Professor David Triggle of New York State University and the other from me (click here to read it), set out future visions for Sustainable Pharmacy. Although different in emphasis, both these presentations focussed on the fact that sustainability was about much more than simple environmental issues and that the major problems faced in moving towards a more sustainable pharmacy lay in the social dimension of providing appropriate medication for all together with the economic problems of delivering such an outcome.
Formal presentations were made in six specific areas:
- Pollution from bulk drug manufacture
- Green Metrics
- Developing environmentally sound pharmaceuticals
- Patenting of biological inventions
- Sustainability & Herbal Medicines
- Use & Disposal of pharmaceuticals
The meeting was organised to promote discussion, but in addition two large discussion sessions were held. The first ran as a series of three parallel workshops exploring green metrics, R&D Requirements for ‘green’ drugs and sustainable use and disposal of pharmaceuticals. The second event was a “World Café” which considered the following three questions:
- On the basis of the conference discussions, your own experience and expertise what appears to be the main road towards more sustainability in pharmacy?
- Having envisioned the main road what are the main road blocks or pot holes that obstruct the passage towards more sustainability in pharmacy?
- Having faced the barriers what can be done to circumvent or even remove them. What can you do in your professional context to promote more sustainability in pharmacy?
The group split randomly into eight groups of five and spent 25 mins discussing the first question with a facilitator. The initial groups then reassembled into eight different groups to discuss the second question and the process repeated for question three.
There was general agreement that ‘health’ rather than ‘curing disease’ would be a better focus for sustainable pharmacy.
In manufacturing, suitable green metrics already exist to measure sustainability. Discharges of pharmaceuticals from manufacturing sites in the developed world were low, although these were largely unregulated. In the developing world discharges could be substantial. It was suggested that an amendment to the GMP regulations would be a driver towards better standards worldwide.
Greener product design was seen as desirable, although it was recognised that neither the relationship of chemical structure to persistence nor the behaviour of APIs in the environment is well understood. Environmental regulators would also like to see a better relationship between market authorisation and environmental risk by modifying the current legislation on human pharmaceuticals to parallel that of veterinary medicines.
A lot of discussion related to drivers for sustainability. It was recognised that although cost and regulation were driving improvements in general business processes, there was no incentive promoting greener drug design. A number of options were discussed ranging from tighter regulation, extensions to patent life and fast tracking vouchers, to additional sales tax on generic products to fund further environmental research.
In the future further collaboration on research was identified as a priority where the focus should be on antibiotic resistance and the potential impact of endocrine disrupting chemicals. There was a general demand for more openness and transparency, with better information flows to all stakeholders being seen as a key objective.
Finally, the meeting came to the following consensus view of sustainable pharmacy:
“Sustainable Pharmacy includes the development, production and use of pharmaceuticals along the whole life cycle in a manner designed to maximize positive impact on human health and to minimize negative impact on the physical, social and cultural environments.”