Pharmaceuticals and the Environment - “Tablett till Toalett”
I attended a very interesting seminar on the topic Pharmaceuticals and the Environment today. It was called “Från Tablett till Toalett” (in English: From pill to the toilet). The seminar was arranged by Mistra Pharma and Svenskt Vatten (in English: The Swedish Water and Wastewater Association), and they took us on a trip under the supervision of moderator Charlotte Permell, from research and devlopment of a pill, through manufacturing, via handling by authorities, County Councils and pharmacies, to the waste water treatment plant. A summary of the presentations and discussion will be published on mistrapharma.se and svensktvatten.se in the coming days but you will find my reflections from today below.
Gisela Holm from Astra Zeneca, representing the industry trade association LIF today, gave a number of examples on initiatives within the industry aimed to reduce environmental impact from pharmaceuticals. Gisela talked about, among other things, green chemistry and the LIF-initiative to publish environmental data on fass.se. Gisela stressed the importance of “green incentives” from society to industry in order to drive the environmental agenda.
Green incentives were also mentioned by Charlotte Unger, environmental manager at Swedish MPA, although she underlined that the main proposal MPA gave in their report on the governmental commission regarding stricter environmenmental standards was to add environmental requirements to GMP. Charlotte presented the new governmental commission they received now in Jan 2011, to elaborate more on that topic (see my blog post from Jan 5, 2011). She also mentioned that the belive that the on-going process to develop a Swedish National Pharmaceutical Strategy, where Sustainable Development is one of 5 focus areas, is a key platform for continued discussions on these issues. Read more about the Pharmaceutical Strategy on my blog post from Dec 12, 2010, and via this link.
The presentation that gave me the strongest surprise today was given by Magnus Thyberg, from TLV (in English: The Dental and Pharmaceutical Benefits Agency). Magnus clearly stressed, in contrast to what I have heard several of his colleagues say before, that TLV already today is entitled to take environmental concerns into consideration in their decisions. This may perhaps not be a surprise to you if you have not been following the discussions the last one to two years, but to me it surely was surprising…
This is interesting news to us all, since in order to be able to develop ideas on economic green incentives, and to implement them on the market, TLV would play a crucial role. Magnus also, like Charlotte Unger, stressed the importance of the ongoing process on the Pharmaceutical Strategy for future discussions.
Magnus received a clear support on his opinion, that TLV has the authority already today to take environmental issues into account, later in the seminar from Karin Johansson, from Ministry of Health. The Minstry of Health seems to have great expectations on the National Pharmaceutical Strategy process and discussions that follows. On a direct question from me, Karin said that in addition to regulatory development (i.e. add environmental requiremenst to GMP) one could if deemed appropriate also look into the pricing and reiumbursement system.
We also had the privilege today to listen to Cecilia Marlow, CEO for Kronans Droghandel and chairman of the Swedish pharmacy association. Cecilia has been very clear with her opinion at several occasions before that patients and pharmacy chains should be able to “act green and responsible”. However, the pricing and reimbursement system, and especially perhaps the generic substitution regulation, prohibits that to a large extent. I recommend you all to read Cecilia’s debate article from today, “Increase the possibility for green pharamecuticals“, where she elaborates on the topic.
I was also happy to listen to the representatives from the County Councils, Annika Christensson from Blekinge and Lars Lööf from Västmanland. They both talked about the role and responsibilities of the County Councils, but clearly stressed the importance of collaborations with all stakeholders. They gave several examples on initiatives they have taken to minimize the environmental impact, and also looked forward to to discussions around the development of the Pharmaceutical Strategy.
We also listen to presentations by Per Baummann from Svensk Dagligvaruhandel (in English roughly the “Supermarket Association”) and Anders Finnson from Svenskt Vatten. Per discussed the new situation where supermarkets since the de-regulation of the Swedish pharmacy market are allowed to sell prescription-free pharmaceuticals, and Anders presented a study performed to see if the de-regulated pharmacy market represents a risk that un-used medicins will not be properly collected. A short conclusion would be “not really, but there is place for improvements”… We also listen to Jes la Cour Jansen from the MistraPharma-project when he described their research on improved waste water treatment methodologies. For more information see mistrapharma.se and my blog post from Oct 29, 2010. Before the panel discussion we also got the privilege to hear Gustav Andersson, politically responsible for environmental issues in Stockholm County Council, describe his views on “what has been done so far, and what more to do”. As you all know, Stockholm County Council with the former environmental director Åke Wennmalm, has been one of the pioneers on pharmaceuticals and environmental matters in Sweden. Gustav mentioned the importance to remain focused on environental issues, and especially on water related matters.
You will find Per, Anders, Jes and Gustaf with all the other presenters on the picture below. As you can see, it was a huge collection of important stakeholders gather in the panel today!
Let me conclude with the following: Good discussions today, and especially interesting was the clear message that also TLV will participate actively in the forthcoming discussions. The seminar ended in a very positive spirit, a lot of ideas of new initiatives and collaborations. And we even got the possibility in the end of the panel discussions to listen to Bengt Simonsson from Teknikmarknad when he described their work with eliminating pharmaceutical residues from waste water up-stream using urine separation.