Search

Aims: Healthcare accounts for 5% of global greenhouse gas emissions, with medicines making a sizeable contribution. Product-level medicine emission data is limited, hindering mitigation efforts. To address this, we created Medicine Carbon Footprint (MCF) Classifier, to estimate, standardize, stratify and visualize medicine carbon footprints., Methods: We used molecular weight and chemical structure to estimate the process mass intensity and global warming potential of the active pharmaceutical ingredient in small molecule medicines. This allowed us to estimate medicine carbon footprints per dose, which we categorized into MCF Ratings, accessible via a searchable web application, MCF Formulary. We performed comparison and sensitivity analyses to validate the ratings, and stratification analyses by therapeutic indication to identify priority areas for emission reduction interventions., Results: We generated standardized medicine carbon footprints for 2214 products, with 38% rated LOW, 35% MEDIUM, 25% HIGH and 2% VERY HIGH. These products represented 2.2 billion NHS England prescribed doses in January 2023, with a total footprint of 140 000 tonnes CO 2 e, equivalent to the monthly emissions of 940 000 cars. Notably, three antibiotics-amoxicillin, flucloxacillin and penicillin V-contributed 15% of emissions. We estimate that implementing the recommended 20% antibiotic prescription reduction could save 4200 tonnes CO 2 e per month, equivalent to removing 29 000 cars., Conclusions: Standardized medicine carbon footprints have utility in assessing and addressing the carbon emissions of medicines, and the potential to inform and catalyse changes needed to align better healthcare and net zero commitments., (© 2024 The Author(s). British Journal of Clinical Pharmacology published by John Wiley & Sons Ltd on behalf of British Pharmacological Society.)

Aim: To evaluate the type (licensed vs unlicensed) and cost of preparations used to fulfil vitamin D prescriptions in England over time, and to compare measured vitamin D content of selected vitamin D preparations against labelled claim. Methods: Retrospective analysis of vitamin D prescription data in primary care in England (2008‐2018). Laboratory analysis of 13 selected vitamin D preparations. Results: Alongside a rise in the number of oral licensed colecalciferol preparations from 0 to 27 between 2012 and 2018, the proportion of vitamin D prescriptions in which licensed vitamin D preparations were supplied increased from 11.8 to 54.2%. However, the use of unlicensed food supplements (dose strength 400‐50 000 IU) remained high, accounting for 39.7% of vitamin D prescriptions in 2018. The two licensed preparations showed mean (±SD) vitamin D content of 90.9 ± 0.7% and 90.5 ± 3.9% of the labelled claimed amount, meeting the British Pharmacopeia specification for licensed medicines (90‐125% of labelled claim). The 11 food supplements showed vitamin D content ranging from 41.2 ± 10.6% to 165.3 ± 17.8% of the labelled claim, with eight of the preparations failing to comply with the food supplement specification (80‐150% of labelled claim). Conclusions: Despite the increasing availability of quality assured licensed preparations, food supplements continued to be used interchangeably with licensed preparations to fulfil vitamin D prescriptions. Food supplements, manufactured under less stringent quality standards, showed wide variations between measured and declared vitamin D content, which could lead to the risk of under‐ and over‐dosing. [ABSTRACT FROM AUTHOR]