1ISG-024 Single-use medical devices in the treatment of chronic diseases: what is the environmental impact?

Background and Importance Single-use medical devices are a common practice in biological drugs administration, potentially improving compliance, reducing the risk of contamination and the need for recharge and sterilisation of used devices. Rising prevalence of autoimmune diseases and therapeutic innovation promote their usage. However, there is limited literature regarding environmental impact resulting from increased plastic consumption, a component of these devices. Aim and Objectives To assess the amount of plastic used in biological treatments with pre-filled pen/syringe single-dose format. Material and Methods Descriptive study consisting in weighing devices for ambulatory dispensing, followed by calculation of expected annual plastic consumption, per drug and dosage. Extrapolation of results considering the total number of patients undergoing treatment with these drugs as of September 2023. Comparison of annual plastic consumption for these patients, assuming as alternative, one reusable pen/device annually. Results Twenty-two drugs available in the institution were selected. Weight values ranged from 5.65g (anakinra) to 74.25g (golimumab), with an average weight of 36.37g per device. Regarding the number of devices needed for annual maintenance, the lower and upper limits were four pens (ustekinumab, risankizumab, tildrakizumab) and 365 syringes (anakinra). This corresponded to an annual use of 215.8g, 268g, 191g and 2062.3g of plastic, per patient, respectively. By analysing the cumulative annual plastic consumption of patients undergoing treatment in the institution (n=948), we obtained the value of 1980.1kg (32972 devices). Assuming the hypothesis of using only one pen/device per year, with refills that may weigh about 9.4g (using the example of interferon beta-1a), we obtained a value of 345.4kg, leading to an annual reduction of 1634.7 kg of plastic. Conclusion and Relevance These systems, maintaining safety, efficacy, and therapeutic adherence, could represent significant savings in environmental impact and production costs. The use of existing technology, such as refillable cartridges, could address this issue. Despite the aforementioned advantages, the significant amount of wasted plastic is clear. A national extrapolation based on relative weight of drug consumption in our institution may indicate that it could be possible to avoid as much as 65 tons per year. An environmental impact of this magnitude should prompt a reflection on the alternatives that can be employed. References and/or Acknowledgements Conflict of Interest No conflict of interest.