Episode 048 | March 20, 2023 | 45:51
Guest: Michelle Sullivan
Published: March 20, 2023
Duration: 45:51
Description
Michelle Sullivan is a seasoned MedTech professional working with health economics, market access, and sustainability in medical technology. She takes us through her journey and how sustainability has become very important — and what the general sustainability landscape in MedTech looks like.
Full transcript
About this transcript
This transcript was automatically generated and may contain inaccuracies, typos, or mistranslations. Episodes recorded before 2024 were transcribed by an on-site model and may have a higher error rate. The content reflects the original conversation to the best of our ability. For the authoritative version, please listen to the audio episode.
There’s layer upon layer of consequences to your actions — positive or negative. At the end of what we do is a person who will get better or not. So not only do we need to understand the impact of the thing we do to the patient, but also the consequences of that and the carbon emissions from the actual result. There are unintended consequences in healthcare when we’ve tried to do the lowest-hanging fruit and inadvertently made things worse.
Hello and welcome. Michelle Sullivan is here — a 20+ year MedTech veteran, head of public affairs for a large global medical-device company, and self-described “accidental eco-warrior.”
Michelle: 20+ years in medical devices. I head public affairs at a global medical-device company. Accidental eco-warrior — I stumbled into this and now it’s a moral imperative. Last year I presented to about 2,000 people on healthcare emissions and what we need to do. Not an “expert expert” — created an expertise from scratch.
How I got into this: my son set up a small charity in 2018 (Green 18). Then a customer asked what my company was doing on environmental sustainability. I went away to find out — joined sustainability groups and realised I didn’t know what they were talking about. Scope 1, 2, 3 — I asked 300 health economists last year and three put their hands up. I did a course at the Cambridge Institute of Sustainability Leadership. That was the start of the moral imperative.
Commercial reality: the NHS was the world’s first health system to commit to net zero. From April, requirements, tenders and legislation are coming through. The “world’s biggest onion” — layer upon layer. Healthcare is treating people; the consequences of treatment are also carbon. Life cycle analysis per patient — where does it start and finish? Unintended consequences: inhalers for asthma had a low-hanging fruit, but if you change to something the patient can’t use as well, the outcome gets worse and emissions for that patient grow. Tricky — have to look holistically without using complexity as an excuse to do nothing.
Health economics + carbon: Michelle (a health economist by training) proposes a third axis: cost / outcome / impact-to-environment. NICE compares treatments to decide bang-for-buck within a fixed budget. We’re not close to doing the z-axis yet — listeners found it hard to take in.
Procurement collaboration: she chairs the ABHI sustainability group. Everyone in the group is collaborative. But we’ve all done business in a competitive environment — taking market share. In environmental sustainability you cannot move from linear to circular alone — 10,000 companies cannot each put 1,000 different recycling bins in hospital A. So joint regulation, joint standards matter.
Lower-hanging fruit: instructions for use. EU still requires paper IFUs; the US allows electronic. A decent proportion of the weight (and shipping energy) of goods is paper IFUs — and 9 out of 10 times they’re pulled out and binned. ABHI, MedTech Europe, MHRA collaborating to change this.
On tender requirements: “let not perfection be the enemy of good.” Make published evidence available on websites. Upskill on both sides — those marking tenders and those answering them. Methodology must be defendable but does not have to be perfect.
Multiple national systems: ~60 health systems looking at the NHS plan. Big challenge: every country wants to know emissions happening within its own borders, but big global organizations manufacture across the world. Two principles: keep it as simple as possible so everyone understands; reward good behaviour rather than scoring zero for imperfection.
Tsunami coming: NHS is a steam train at a faster rate of knots than people understand. From a purely commercial perspective — even if you don’t care about the planet — you’ll be worse off in tenders. With 10 marks for sustainability, if you don’t have your ducks in a row you’ll sacrifice margin to compete.
Michelle’s personal footprint test: she does her best and her lifestyle still requires 5.5 planets. We are talking about keeping our planet habitable for us. Cultural shift — when will big gas-guzzling vehicles be embarrassing rather than status symbols? Probably not far off.
Frederik: Denmark celebrated as a green nation runs at 4 planets per year. Not a leading nation when you include consumption and agriculture. Things will accelerate massively this year as extreme weather brings sustainability front and centre.
Thanks Michelle. Thanks for listening — please subscribe and share.