Episode 082 | April 1, 2024 | 48:03
Guest: Amy Booth & Chris Winchester
Published: April 1, 2024
Duration: 48:03
Description
How companies are setting targets and improving reporting quality, and the need for tangible emission reduction. Frederik, Amy, and Chris delve into progress and challenges of decarbonizing the healthcare sector — the potential of telemedicine and the importance of considering the entire patient care pathway, plus shifting focus from reporting to creating tangible results.
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.
Hello and welcome. Amy Booth and Chris Winchester return — they previously joined to discuss their paper on pharma’s decarbonization efforts. Today: what’s changed since then.
Amy: Last year we mapped where pharma was — targets, GHG reporting, solutions, landscape. Since then almost all the laggards have changed their goals. Impressive speed.
Chris (Oxford PharmaGenesis, supplier to pharma): At ISMPP earlier this year the topic felt new — “this is coming.” Just months on it’s definitely arriving. Clients now request EcoVadis assessments — we got silver. EcoVadis covers carbon, biodiversity, water etc., and is recognised by multiple clients so we don’t redo from scratch. We’re committing to SBTi in the next few months.
500-person professional services firm — emissions are largely business flights. Some clients used to ask us to fly 4-5 people to New York for a single pitch — pitches are now virtual. Effort goes into established relationships. Pandemic shifted tolerance for building rapport remotely — we have clients we’ve never met in person until two years in, and then it’s a hug not a handshake.
Some clients set carbon budgets per person per year. When you’re out, you’re out for the year. Medical congresses bounced back fully to in-person.
Amy: “Sitting in the library surrounded by books on climate change and economics from 10-20 years ago — sometimes demoralising that we haven’t moved on much from that space.” Knowledge has been available for so long.
Targets and reporting have improved a lot — supply-chain emissions reporting is up. But targets and reporting risk becoming a tick-box exercise — emphasis must shift to physical reduction, tangible emission reduction. Regulation penalises non-reporting but not non-reduction. Companies publish what they have to. Concerns about greenwashing make them “green hush” instead, which means they don’t share solutions or engage with challenges. Operating in silos.
On individual-product carbon footprinting: standardised method needed; companies need exact data; health systems unclear on how they’ll use it; companies unwilling to publish until numbers are perfect and standardised. Misalignment.
Healthcare-pathway thinking: health systems frame in patient outcome (always priority, environmental co-benefits welcome); companies frame in financial risk and opportunity. Pharmaceutical is often considered gold standard of treatment — so attention falls on reducing impact of that product. But it’s one part of the pathway. If you take a vaccine you may never enter the healthcare system. Hard because of counterfactuals and responsibility allocation. Some see pathway-thinking as legitimate; others view it as an excuse by pharma to not engage with its own product footprint.
Chris’s brutal comment: someone who stays alive may consume more carbon than someone who dies. So if the aim is to save lives, it’s about avoiding healthcare utilisation, disability and keeping people active.
Where does R&D carbon go? 20-30 years of failed Alzheimer’s clinical development — tens of billions of dollars and carbon emissions. If a big pharma carries it, it’s in their footprint. If a small biotech folds, those emissions don’t get reported anywhere in the life cycle of medicines.
Frederik: CRO clinical-trial emissions are often cost-extrapolated — given how expensive trials are, that’s not necessarily a fair carbon estimate. We did a pilot with Janssen building an LCA tool for clinical-trial designers — designers can model “telemedicine vs in-person consultation” scenarios. Once design decisions are baked in and the drug is on the market, changing them is nearly impossible — refile takes months to years.
Amy on eco-design: building sustainability in from the beginning is the right approach. Cynical concern: companies might prioritise speed-to-market and use regulation as an excuse not to change later — so we end up with chronically unsustainable products. Incentives should encourage eco-design upstream.
Amy on telemedicine review: her department reviewed the literature. Bulk of studies only look at travel saved. We need broader thinking — what if a telemedicine consult misses a vital diagnosis and the patient ends up in ICU a week later, what’s that environmental impact?
What changed in two years:
Chris: wasn’t really on our radar professionally two years ago. Now transformed. Manufacturing/distribution were the early focus; now professional services like ours feel the pressure too. NHS getting more vocal each year.
Amy: when I first lectured on this at Oxford I had to start from scratch. Now the baseline knowledge is rising every time. Maybe we need to change the systems we operate in — shift from treating illness to promoting health. “Selling health, not drugs.” Use industry’s resources for non-drug interventions.
Frederik: Pharma sometimes leans into certifications without absolute reductions. Contract manufacturers and CROs create gray zones — companies could lawyer up to keep those emissions out of their books. The right mindset is impact mindset, not reporting mindset. Falck example: technically the ambulance is the procurer’s responsibility, but Falck took on the emissions to push clients toward electric ambulances and better route planning.
Thanks Amy and Chris. Thanks for listening — please share, comment, subscribe.