Carbon Footprint of Antibody-Based Drugs and Biologics Using Hybrid Life Cycle Assessment.

Biological engineering has emerged since the 1980s as one of the most efficient technologies to develop new medicines. The monoclonal antibody platform is the most widely used, representing about 15-20% of drug sales. Only scarce and partial monoclonal antibody life cycle assessments (LCAs) are reported. We estimate the cradle-to-pharmacy gate carbon footprint of monoclonal antibodies from the pharmacopeia on the market (n = 103) using the full life cycle inventory of the medicines, encompassing antibody production, packaging production, transport, medicine manufacturing, and associated corporate emissions using a hybrid LCA/environmentally extended input-output model. Monoclonal antibody-based drugs have an important carbon footprint with a mean of 169.7 kgCO2e/vial or prefilled syringe (95% CI 10.1-621.1) and 371.4 kgCO2e/month (95% CI 23.1-1,479.5) vs. 14.1 kgCO2e/month (95% CI 0.33-36.2) for an oral treatment. A large fraction of emissions is emerging from corporate emissions. The 95% CI surrounding these estimations is about ±35%. Among subparts, antibody production emissions largely vary from 7.1 to 20,206 kgCO2e/g of antibody (mean 472 kgCO2e/g, 95% CI 8.2-2,529), depending on the production scale. As an illustration, the carbon footprint of second-line treatment options in rheumatoid arthritis ranges from 286 to 2,047 kgCO2e/year. In cancer immunotherapy, alternative weight-adjusted dosing strategies lead to a 10-20% mitigation in greenhouse gas emissions, while "low-dose" strategies may mitigate emissions by 2- to 10-fold. Antibody-based drugs have a significant carbon footprint, although highly variable. This database allows for a better understanding of the carbon footprint associated with these drugs, in order to better eco-design care pathways.