Sustainable for patients,
Sustainable for health systems,
Sustainable for the planet.
The current health care system is over-prescribing medications. Studies suggest we over-prescribe some drug classes by 20-30%.
Prescribing practices can be influenced by various factors. However, overprescribing can occur as a result of not providing better alternatives, generalization of the use of the medicine for all patients with the condition, not recognizing condition changes, the patient no longer needing the medicine. There are potential harms to these medications, which need to be addressed and led to the formation of the Canadian medication safety coalition.
The financial cost of prescribed drug spending can be found in this Canadian Institute for Health Information document. (See page 6)
“Public drug program spending accounted for 43.6% of the $34.3 billion of prescribed drug spending in 2019, as reported in CIHI’s National Health Expenditure Trends, 1975 to 2019. The public share of prescribed drug spending varied among provinces, ranging from 31.7% in New Brunswick and 34.0% in Newfoundland and Labrador to 47.4% in Manitoba and 48.6% in Saskatchewan. Outside of the public sector, prescribed drug spending financed by private insurers was $12.7 billion (36.9%), with the remaining $6.8 billion (19.9%) financed by Canadian households.1 Public drug program spending does not include spending on drugs dispensed in hospitals or on those funded outside public drug programs (e.g., through cancer agencies).”
These costs have increased since 2019 and these numbers do not include over-the -counter medications. The money spent on over-prescribed medications could be moved to other areas of a strained Canadian health system.
Deprescribing and finding alternatives would improve human health, reduce health care spending, and reduce greenhouse gas emissions.
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The production of medications contributes 48% of the greenhouse gases within a Primary Healthcare office. The emissions from metered dose inhalers add another 13%. If an office could decrease medications by 10%, it would be as much as the Building Energy and Water and Waste GHGs combined! The waste from medications results in further harms to the environment.
The data shown above was extracted from The Lancet 2021 Tennison et al. article and translated to percentages.
If we follow appropriate prescribing guidelines, especially for the elderly, we can decrease medications by well over 5%. This would save a 200-bed hospital in Canada over 100 Tonnes of CO2 equivalents, and over $200,000 per year.
Our low-hanging fruit tree illustrates the amount of CO2 saved with various environmental initiatives. In terms of cost and environmental impact, deprescribing is one of the best fruits to pick. Read the full article here.
We also need to demand that medications are produced with their carbon footprint in mind. We need to support companies which are working hard to make greener products. We should be able to make choices about medications based, in part, on a climate-score.
The environmental side effects of medications: Reducing the carbon footprint of psychiatry.
We will be adding rating systems for suppliers to our website very soon. We cannot rate individual products yet because we do not know the life cycle analysis for all the things we buy. We can, however, rate the companies which make the products.
The Canadian Coalition for Green Health Care's Sustainable Prescribing working group created an infographic with several like-minded organisations which outlines the options of the green prescriber. View the infographic HERE.
Hospital Pharmacies and the Climate Crisis
October 26th, 2022 at 8pm ET
The Canadian Coalition for Green Health Care, PEACH Health Ontario, and CASCADES partnered to welcome Dr. Shellyza Moledina Sajwani, for an overview of climate change's relevance to pharmacy. She specifically focuses on tangible objectives that can be completed within a hospital pharmacy setting, using the example of the Ottawa Hospital Pharmacy Environmental Stewardship Committee.
Pharmaceuticals in the Environment: Impacts on non-target organisms
March 28th, 2023 at 5:30 pm PST/8:30pm EST
Join the Canadian Coalition for Green Health Care, PEACH Health Ontario, and CASCADES for an interactive webinar with pharmacist Gigi Wong who will present on the topic of pharmaceuticals in the environment.
In this one-hour session Gigi will describe how pharmaceuticals enter the environment; detail the environmental classification for pharmaceuticals and the properties of persistence, bioaccumulation and toxicity; as well as provide one example of wildlife that has been negatively impacted by the use of pharmaceuticals.
View the presentation slides HERE.