How do French patients perceive the environmental impact of drugs?

  • Sirajdine Cherif Faculty of Pharmacy, University of Strasbourg, 74 route du Rhin, 67400 Illkirch-Graffenstaden, France https://orcid.org/0009-0004-6365-4359
  • Bruno Michel NeuroCardiovascular Pharmacology and Toxicology Laboratory UR7296, Strasbourg Biomedical Research Center (CRBS), University of Strasbourg & Pharmacy Department, Strasbourg University Hospitals, France https://orcid.org/0000-0001-5961-1584
Keywords: Chronic disease, drug evaluation, health literacy, patient preference, sustainable developement, drug recycling, community pharmacy

Abstract

Medications account for nearly one-third of healthcare-related greenhouse gas emissions in France, yet their environmental impact remains largely overlooked in public discourse. This study aimed to explore how patients with chronic illnesses perceive their medications’ ecological footprint and identify opportunities for a more sustainable pharmaceutical model supported by patient engagement. An anonymous survey was conducted via an online survey among French adults with chronic illnesses (asthma, diabetes, multiple sclerosis, rheumatoid arthritis, and chronic myeloid leukaemia) to explore their awareness and attitudes regarding the environmental impact of medications. The 11-item questionnaire was distributed via patient associations and social media over two weeks (October 15–November 1, 2024). Data were analysed using descriptive and comparative statistics; open-ended responses were thematically explored. Nearly 90.0% (n=202) of respondents were willing to choose medications with a lower environmental impact, provided their efficacy and tolerability were equivalent. However, 47.0% (n=104) of patients were unsure if there is a link between environmental impact and medication effectiveness, highlighting a significant lack of clarity on the topic. This uncertainty reinforces the need for accessible and transparent information. Over 88.0% (n=199) of participants wished to be informed about the environmental footprint of their treatments, favouring labelling on medication packaging. While most patients were willing to act individually—by returning unused medications or choosing greener options—only 68.7% (n=155) reported using recycling programs, a rate below the national documented average of 81.0%. Patients also expressed a strong desire for systemic change: 87.0% (n=195) supported the inclusion of environmental criteria in national medication evaluation policies, and they also expected the pharmaceutical industry to invest in sustainability, while remaining cautious about potential economic trade-offs. In conclusion, patients are open to contributing to a more sustainable healthcare model, but a lack of clear, trustworthy information and accessible environmental options hinders their willingness. Public institutions, healthcare providers, and pharmaceutical companies must work together to support this shift by raising awareness and making sustainable choices visible, credible, and actionable within the patient care pathway.

References

The Shift Project, Décarbonons les industries du médicament - Rapport intermédiaire, janvier 2025. [Cited 2025 May 1]. Available from: https://theshiftproject.org/article/decarbonons-industries-du-medicament/

Antibiotiques, halte à la surconsommation [Internet]. Sante-pratique-paris. 2018 [cited 2025 Aug 3]. Available from: https://sante-pratique-paris.fr/sante-publique-dossier/antibiotiques-halte-a-la-surconsommation/

France: health system summary 2024| European Observatory on Health Systems and Policies [Internet]. [cited 2025 Aug 3]. Available from: https://eurohealthobservatory.who.int/publications/i/france-health-system-summary-2024

Laviolle B, Degon PF, Gillet-Giraud C, Thiveaud D, Lechat P, Boïko-Alaux V, et al. Comment prendre en compte la dimension éco-responsable des produits de santé tout au long de leur cycle de vie? Therapies. 2023 Nov;S0040595723001786. https://doi.org/10.1016/j.therap.2023.10.012

Wilkinson A, Woodcock A. The environmental impact of inhalers for asthma: A green challenge and a golden opportunity. Br J Clin Pharmacol. 2022;88(7):3016-22. https://doi.org/10.1111/bcp.15135

Wilkinson JL, Boxall ABA, Kolpin DW, Leung KMY, Lai RWS, Galbán-Malagón C, et al. Pharmaceutical pollution of the world's rivers. Proc Natl Acad Sci. 2022 Feb 22 [cited 2025 May 2];119(8). Available from: https://pnas.org/doi/10.1073/pnas.2113947119

De nouvelles orientations mondiales visent à réduire la pollution issue de la fabrication des antibiotiques. [cited 2025 May 2]. Available from: https://www.who.int/fr/news/item/03-09-2024-new-global-guidance-aims-to-curb-antibiotic-pollution-from-manufacturing

Baroka IU. Pharmaceutical waste management: sources, environmental impacts, and sustainable solutions. Pharm Rep. 2025 June 1;5(1):95-95. https://doi.org/10.51511/pr.95

Ministère de la Santé et de la Prévention, Planification écologique du système de santé - Feuille de route, mai 2023. [cited 2025 May 1]. Available from : https://sante.gouv.fr/IMG/pdf/planification-ecologique-du-systeme-de-sante-feuille-de-route-mai-2023.pdf.

Cohen ES, Kringos DS, Grandiek F, Kouwenberg LHJA, Sperna Weiland NH, Richie C, et al. Patients' Attitudes Towards Integrating Environmental Sustainability Into Healthcare Decision‐Making: An Interview Study. Health Expect Int J Public Particip Health Care Health Policy. 2025 Jan 19;28(1):e70155. https://doi.org/10.1111/hex.70155

Håkonsen H, Dohle S, Rhedin H, Hedenrud T. Preferences for medicines with different environmental impact - A Swedish population-based study. Environ Adv. 2023 July 1;12:100358. https://doi.org/10.1016/j.envadv.2023.100358

Della Vecchia C, Leroy T, Bauquier C, Pannard M, Sarradon-Eck A, Darmon D, et al. Willingness of French General Practitioners to Prescribe mHealth Apps and Devices: Quantitative Study. JMIR MHealth UHealth. 2022 Feb 11;10(2):e28372. https://doi.org/10.2196/28372

France. IDF Europe Site. [cited 2025 Aug 4]. Available from: https://idf.org/europe/our-network/our-members/france/

European Commission / EACEA, 2025. The situation of young people in the European Union. EU Youth Report 2024. Luxembourg: Publications Office of the European Union [cited 2025 Aug 7].

Scholz F, Börner N, Schust SA, Schardey J, Kühn F, Renz B, et al. Focus on patient perspectives in climate action policies for healthcare. A German survey analysis on what patients are willing to do. Front Public Health. 2024 Nov 26;12:1477313. https://doi.org/10.3389/fpubh.2024.1477313

Luís S, Lima ML, Poggio L, Aragonés JI, Courtier A, Roig B, et al. Lay people and experts' risk perception of pharmaceuticals in the environment in Southwestern Europe. Regul Toxicol Pharmacol RTP. 2020 Nov;117:104783. https://doi.org/10.1016/j.yrtph.2020.104783

Dohle S, Campbell VEA, Arvai JL. Consumer-perceived risks and choices about pharmaceuticals in the environment: a cross-sectional study. Environ Health Glob Access Sci Source. 2013 June 5;12:45. https://doi.org/10.1186/1476-069X-12-45

Comment les Français trient-ils leurs médicaments chez eux ? 2024 [cited 2025 May 23]. Available from: https://www.cyclamed.org/tri-affine-au-domicile-usage-du-medicament-raisonne-ce-que-revele-le-barometre-bva-sur-les-comportements-des-francais-et-les-mnu/

CEPSA.com [cited 2025 May 23]. SIGRE - Medication Disposal in Spain. Available from: http://www.moeveglobal.com/en/planet-energy/environment/sigre-container-medication-disposal-in-spain

Returning expired medicines has increased in Finland. [cited 2025 May 23]. Available from: https://www.oriola.com/news-and-releases/news/2021/returning-expired-medicines-has-increased-in-finland

Zanobini P, Del Riccio M, Lorini C, Bonaccorsi G. Empowering Sustainable Healthcare: The Role of Health Literacy. Sustainability. 2024 May 9;16(10):3964. https://doi.org/10.3390/su16103964

Déprescription médicamenteuse : un colloque pour une dynamique collective. 2025 [cited 2025 May 23]. Available from: https://www.grand-est.ars.sante.fr/deprescription-medicamenteuse-un-colloque-pour-une-dynamique-collective

Published
2025-08-12
How to Cite
Cherif, S., & Michel, B. (2025). How do French patients perceive the environmental impact of drugs?. Pharmacy Reports, 5(1), 103. https://doi.org/10.51511/pr.103