[Life cycle assessment of medicines in the hospital setting: Feasibility and integration perspectives from the adalimumab case].

OBJECTIVES

To assess the feasibility of conducting a life cycle assessment of adalimumab in order to estimate its carbon footprint and to explore the integration of such an approach into hospital referral decisions.

METHODS

Seven adalimumab products in prefilled pen presentations were analysed (one originator and six biosimilars, at 40mg and 80mg doses). The Carebone® tool, developed by Assistance publique-Hôpitaux de Paris, was used to perform a life cycle assessment including the production of the active substance, excipients, packaging materials, energy consumption during formulation and packaging, transport, and end-of-life of packaging. Data were collected from regulatory databases and from documentation provided by pharmaceutical companies.

RESULTS

The carbon footprint of adalimumab pens varies between 515 and 1887 grams of carbon dioxide equivalent, depending on the product and dosage. The production of the active substance is the main source of emissions (up to 70% of the total), whereas excipients have a negligible impact. The estimates are consistent with available industrial data and with results reported for other injectable devices.

CONCLUSIONS

This study provides the first comprehensive life cycle assessment of adalimumab, confirming the technical feasibility of this approach using the Carebone® tool, while highlighting challenges related to industrial data collection. It supports the inclusion of environmental criteria in the evaluation and selection of medicines in hospitals, alongside established clinical and economic considerations.