The Climate Impact of Medicines in the Hospital Sector: A Scoping Review.

Climate change poses a significant challenge for global health. The World Health Organization estimates 250 000 additional annual deaths between 2030 and 2050 due to global warming. The healthcare sector is a major contributor to greenhouse gas (GHG) emissions, accounting for approximately 4.4%-5.5% of a country's total carbon footprint, with medicines contributing 5%-10%. This scoping review provides an overview of existing literature on the climate impact of medicines in the hospital sector and identifies knowledge gaps. The review followed PRISMA-ScR guidelines, conducting a comprehensive literature search in PubMed and Embase. Peer-reviewed articles published in the last 20 years, reporting original data on GHG emissions from medicines in the hospital sector were included. Articles were categorized based on therapeutic area, enabling a structured mapping of current areas of evidence. Of the 2986 studies identified, 32 were included. Most focused on emissions from inhaled anaesthetic gases (n = 15), followed by inhaler therapies (n = 6), total healthcare systems (n = 4), ophthalmology (n = 3), surgical procedures (n = 2) and other areas (n = 2). The findings show that research on the climate impact of medicines in the hospital sector remains limited. Knowledge gaps persist across most therapeutic areas, highlighting the need for research to inform climate-friendly strategies and support decision-making.