Effect of alternative dosing strategies of pembrolizumab and nivolumab on health-care emissions in the Netherlands: a carbon footprint analysis

IF 24.1 1区 医学 Q1 ENVIRONMENTAL SCIENCES Lancet Planetary Health Pub Date : 2024-11-01 DOI:10.1016/S2542-5196(24)00245-6
{"title":"Effect of alternative dosing strategies of pembrolizumab and nivolumab on health-care emissions in the Netherlands: a carbon footprint analysis","authors":"","doi":"10.1016/S2542-5196(24)00245-6","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Hospitals contribute substantially to greenhouse gas emissions and face a moral obligation to prioritise emission reduction. Drugs constitute an important component of the greenhouse gas emissions of hospitals. Alternative dosing strategies (ADS) have been implemented to improve the cost-effectiveness of pembrolizumab and nivolumab. However, the impact of these ADS on greenhouse gas emissions remains unknown. Therefore, we aimed to analyse the effect of ADS implementation on the carbon emissions of treatment with pembrolizumab and nivolumab.</div></div><div><h3>Methods</h3><div>We used a process-based lifecycle assessment to quantify the environmental impact of pembrolizumab and nivolumab, focused on equivalent carbon dioxide emissions (CO<sub>2</sub>e). Lifecycle inventory and impact data from Erasmus University Medical Center (Rotterdam, Netherlands) were used to calculate the CO<sub>2</sub>e for pembrolizumab and nivolumab, their dosing intervals, and the impact of ADS on CO<sub>2</sub>e. The functional unit of the study was the administration of a single dose of pembrolizumab or nivolumab.</div></div><div><h3>Findings</h3><div>In 2022, the annual carbon emissions related to pembrolizumab and nivolumab treatment in the Erasmus University Medical Center were 445 tons of CO<sub>2</sub>e, averaging 94 kg of CO<sub>2</sub>e per dose. Pharmaceutical production was the main driver of treatment-related carbon emissions (mean 92·9% of total emissions). Applying ADS resulted in 21–26% and 9–11% CO<sub>2</sub>e reductions for pembrolizumab and nivolumab, respectively.</div></div><div><h3>Interpretation</h3><div>This study shows the environmental impact of pembrolizumab and nivolumab treatment and calls for further implementation of ADS for pembrolizumab, nivolumab, and other anti-PD-(L)1 monoclonal antibodies, and more sustainable pharmaceutical production processes. Our findings create environmental awareness and contribute to the promotion and understanding of health-care practices with lower carbon emissions.</div></div><div><h3>Funding</h3><div>None.</div></div>","PeriodicalId":48548,"journal":{"name":"Lancet Planetary Health","volume":null,"pages":null},"PeriodicalIF":24.1000,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Lancet Planetary Health","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2542519624002456","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ENVIRONMENTAL SCIENCES","Score":null,"Total":0}
引用次数: 0

Abstract

Background

Hospitals contribute substantially to greenhouse gas emissions and face a moral obligation to prioritise emission reduction. Drugs constitute an important component of the greenhouse gas emissions of hospitals. Alternative dosing strategies (ADS) have been implemented to improve the cost-effectiveness of pembrolizumab and nivolumab. However, the impact of these ADS on greenhouse gas emissions remains unknown. Therefore, we aimed to analyse the effect of ADS implementation on the carbon emissions of treatment with pembrolizumab and nivolumab.

Methods

We used a process-based lifecycle assessment to quantify the environmental impact of pembrolizumab and nivolumab, focused on equivalent carbon dioxide emissions (CO2e). Lifecycle inventory and impact data from Erasmus University Medical Center (Rotterdam, Netherlands) were used to calculate the CO2e for pembrolizumab and nivolumab, their dosing intervals, and the impact of ADS on CO2e. The functional unit of the study was the administration of a single dose of pembrolizumab or nivolumab.

Findings

In 2022, the annual carbon emissions related to pembrolizumab and nivolumab treatment in the Erasmus University Medical Center were 445 tons of CO2e, averaging 94 kg of CO2e per dose. Pharmaceutical production was the main driver of treatment-related carbon emissions (mean 92·9% of total emissions). Applying ADS resulted in 21–26% and 9–11% CO2e reductions for pembrolizumab and nivolumab, respectively.

Interpretation

This study shows the environmental impact of pembrolizumab and nivolumab treatment and calls for further implementation of ADS for pembrolizumab, nivolumab, and other anti-PD-(L)1 monoclonal antibodies, and more sustainable pharmaceutical production processes. Our findings create environmental awareness and contribute to the promotion and understanding of health-care practices with lower carbon emissions.

Funding

None.
查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
pembrolizumab和nivolumab的替代剂量策略对荷兰医疗排放的影响:碳足迹分析
背景医院对温室气体排放贡献巨大,因此在道义上有义务优先减排。药物是医院温室气体排放的重要组成部分。为了提高 pembrolizumab 和 nivolumab 的成本效益,已经实施了替代剂量策略 (ADS)。然而,这些 ADS 对温室气体排放的影响仍然未知。因此,我们旨在分析 ADS 的实施对使用 pembrolizumab 和 nivolumab 治疗的碳排放的影响。方法我们使用基于流程的生命周期评估来量化 pembrolizumab 和 nivolumab 对环境的影响,重点是等量二氧化碳排放(CO2e)。我们利用伊拉斯谟大学医学中心(荷兰鹿特丹)提供的生命周期清单和影响数据,计算了pembrolizumab和nivolumab的二氧化碳当量、给药间隔以及ADS对二氧化碳当量的影响。研究结果2022年,伊拉斯谟大学医学中心每年与pembrolizumab和nivolumab治疗相关的碳排放量为445吨二氧化碳当量,平均每剂94千克二氧化碳当量。药品生产是治疗相关碳排放的主要驱动因素(平均占总排放量的 92-9%)。应用ADS后,pembrolizumab和nivolumab的二氧化碳排放量分别减少了21%-26%和9%-11%。 这项研究显示了pembrolizumab和nivolumab治疗对环境的影响,并呼吁对pembrolizumab、nivolumab和其他抗PD-(L)1单克隆抗体进一步实施ADS,并采用更具可持续性的制药生产工艺。我们的研究结果提高了人们的环保意识,有助于推广和了解碳排放量较低的医疗保健方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 去求助
来源期刊
CiteScore
28.40
自引率
2.30%
发文量
272
审稿时长
8 weeks
期刊介绍: The Lancet Planetary Health is a gold Open Access journal dedicated to investigating and addressing the multifaceted determinants of healthy human civilizations and their impact on natural systems. Positioned as a key player in sustainable development, the journal covers a broad, interdisciplinary scope, encompassing areas such as poverty, nutrition, gender equity, water and sanitation, energy, economic growth, industrialization, inequality, urbanization, human consumption and production, climate change, ocean health, land use, peace, and justice. With a commitment to publishing high-quality research, comment, and correspondence, it aims to be the leading journal for sustainable development in the face of unprecedented dangers and threats.
期刊最新文献
Climate injustice: lessons from the Philippines' jeepney modernisation programme Climate emotions, thoughts, and plans among US adolescents and young adults: a cross-sectional descriptive survey and analysis by political party identification and self-reported exposure to severe weather events Correction to Lancet Planet Health 2024; 8: e754–65 The effect of next-generation, dual-active-ingredient, long-lasting insecticidal net deployment on insecticide resistance in malaria vectors in Benin: results of a 3-year, three-arm, cluster-randomised, controlled trial Correction to Lancet Planet Health 2024; 8: e804–12
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1