Citation: Gerner S, Schneider A, “Paving the Way to Zero Carbon Emission Combination Products: Insights From the Ypsomate Zero Case Study. ONdrugDelivery, Issue 112 (Sep/Oct 2020), pp 56–59.
Sebastian Gerner and Andreas Schneider discuss the relationship between the medical device industry and the global issue of plastic waste. The authors introduce YpsoMate Zero as a case study, Ypsomed’s net-zero carbon emission prefilled autoinjector.
SELF-MEDICATION AND SUSTAINABILITY: TURNING THE VICIOUS CYCLE INTO A VIRTUOUS ONE
When Susanna, who has been living with arthritis for about five years, started taking her newly prescribed biologics in a prefilled autoinjector, she realised that it really did reduce pain, swelling and joint stiffness. This prompted her rheumatologist to propose the new treatment option for the coming years to stop further joint erosion. However, she soon discovered that her injection routine would lead to a considerable amount of waste.
“Self-care should help to preserve natural resources and contribute to minimising waste and pollution.”
In fact, more than 16 billion injections are administered in hospitals and care home facilities worldwide every year. A significant portion of these injection devices heads straight for the landfill – studies in various countries have revealed that, shockingly, less than 10% of diabetes patients used specific containers for the disposal of their needles and syringes. For patients living with chronic diseases, injection devices are an indispensable part of their disease management routine. Instead of burdening the environment – and unnecessarily forcing patients to adopt non-eco-friendly habits – self-care should help to preserve natural resources and contribute to minimising waste and pollution. Self-care should have minimal impact on our environment.
Easy-to-use self-injection systems contribute to shifting the point of care from the hospital to the home, and are currently demonstrating success in doing so. At-home treatment of chronic diseases not only improves access to healthcare and lowers overall costs, it also helps to minimise the overall environmental impact by, for example, reducing the need for travel or to use hospital infrastructure and resources. The increasing adoption of single-use and prefilled self-injection devices, however, has put the pharmaceutical industry in general, and the drug delivery device manufacturers in particular, in the public spotlight with respect to some of the most pressing issues of our time: the use of plastics and its effect on the environment.
There is little debate about the responsibility of the pharmaceutical supply chain to help minimise the impact of healthcare on the environment and contribute to a more sustainable future. Additionally, there is considerable scope for systemic improvements where we see healthcare-related environmental impacts. However, the environmental costs of medical devices, healthcare facilities and care concepts are often overlooked. As Ypsomed’s Chief Executive Officer, Simon Michel, states: “Every year we manufacture millions of self-injection devices. As this number continues to increase, it puts us at the forefront of plastic waste – one of the world’s biggest environmental challenges. We need to act now, and send a clear signal that we are taking our responsibility seriously.”
Ypsomed has adopted a corporate sustainability programme that embraces environment-friendly and resource-saving actions. The vision is clear: Ypsomed is committed to achieving net-zero carbon emissions by 2030. Step-by-step, the company is reorienting its manufacturing processes, supply chain and self-injection device designs towards a less resource-intensive, more circular mindset. Ypsomed is shifting from a linear take-make-waste economy to a circular way of thinking, following three core principles proposed by leading private and public institutes alike:
- Design out waste and pollution – consider waste as a design flaw and use new materials and technologies.
- Keep products and materials in use – enable product and component reuse, repair and re-manufacturing. Allow materials to be recovered so that they do not end up in landfill.
- Regenerate natural systems – restore valuable nutrients to the soil and other ecosystems to enhance our natural resources.
Despite all the challenges of achieving net-zero carbon emissions by 2030, Ypsomed has already set out on the journey to zero. This article introduces the case study of YpsoMate Zero, a prefilled autoinjector with net-zero carbon emissions and a first step towards achieving Ypsomed’s net-zero carbon emissions by the 2030 goal. The case study illustrates how the use of alternative materials, optimisations along the supply chain and offsetting the remaining carbon foot print lead to an environment-friendly device offering without compromising on usability and patient safety.
INTRODUCING YPSOMATE ZERO – THE CARBON NEUTRAL PREFILLED AUTOINJECTOR
There are two main reasons that the YpsoMate autoinjector for use with prefilled 1.0 mL syringes was selected to have its environmental impact minimised (Figure 1). First, YpsoMate is a state-of-the-art prefilled autoinjector that provides patients with a simple and convenient automatic two-step injection procedure. YpsoMate prioritises patient safety and the ability to use the device effectively. However, its single-use nature has put the prefilled autoinjector at the forefront of the global plastic challenge, urging Ypsomed to take action. Second, YpsoMate 1.0 mL is used across chronic disease areas where patients regularly self-inject over a long period of time. Patients pull off the cap to remove the needle shield from the prefilled syringe, press the autoinjector onto the skin to trigger the injection and then dispose of the autoinjector after use. Continued YpsoMate-based self-injection leads to a considerable accumulation of waste during therapy. YpsoMate 1.0 mL, therefore, is a key priority when it comes to optimising the environmental costs of self-injection systems.
Before optimising the YpsoMate device design to minimise its carbon footprint, it was essential to gain detailed insight into the environmental impacts associated with the device as it stood. A lifecycle assessment was conducted to obtain a quantitative and systematic perspective on the environmental costs of the two-step autoinjector over its entire lifecycle, including raw materials, manufacturing and final disposal. Figure 2 shows the YpsoMate autoinjector value chain and highlights those areas included in the case study.
Not only did the lifecycle analysis assess those process steps controlled by Ypsomed, but also included the end of life of the final assembled drug product to better understand the environmental impact associated with its disposal. A breakdown of the total carbon emission of the YpsoMate autoinjector is shown in Figure 3. The lifecycle analysis highlighted the environmental hotspots and enabled evidence-based and data-driven design optimisations.
The analysis provided two key insights that guided the subsequent optimisation efforts to minimise the environmental effects of the device. First, the materials used for the device components had the greatest impact on the device total carbon emissions. In fact, the polymer components, such as the device housing, the syringe holding unit and the components used to remove the needle guard, accounted for about 60% of the total carbon emissions of the device. Second, the analysis confirmed that the packaging materials used to ship the device components either in-house or to the final assembly sites also constituted a significant environmental impact, and were therefore a key priority. The weight of the materials used to securely package the autoinjectors is more than half of the overall device weight, and contributed to about 20% of the total carbon emissions. Interestingly, the lifecycle analysis showed that the transportation of raw materials was less critical for the environmental impact of the device.
“Before optimising the YpsoMate device design to minimise its carbon footprint, it was essential to gain detailed insight into the environmental impacts associated with the device as it stood.”
The lifecycle analysis thereby provided the basis for reducing the YpsoMate carbon emissions, directing the engineering efforts towards the most pressing environmental hotspots:
- Use of alternative polymers for selected device components and packaging (e.g. device housing and packaging tray)
- Close the loop for the packaging of device components and device sub-assemblies (e.g. trays, pallets)
- Implement design for recycling into the development process.
The iterative implementation of the aforementioned measures was key to eliminating waste, fostering a sustainable use of natural resources, engendering resource efficiency and, most importantly, avoiding carbon emissions. As illustrated in Figure 4, several optimisation loops have resulted in a substantial reduction of the total carbon emissions.
However, a state-of-the-art injection device cannot be designed in such a way that the carbon footprint is zero. With the aim of creating a fully carbon neutral prefilled autoinjector, a separate programme is needed to offset the remaining carbon footprint. Ypsomed invests in its own programme to substitute carbon emissions. The Ahueni reforestation programme in Kenya enables the generation of carbon emission certificates while committing to the highest industry standards. Since its launch three years ago, the programme has planted 350,000 indigenous tree species to bind carbon in the long run, create new habitats for plants and animals and proactively include local communities in the project to regenerate their ecosystem.
COLLABORATION TO ENABLE ZERO CARBON EMISSION COMBINATION PRODUCTS
“With the aim of creating a fully carbon neutral prefilled
autoinjector, a separate programme is needed to
offset the remaining carbon footprint.”
The world’s first net-zero carbon emission autoinjector paves the way towards carbon neutral combination products. On the one hand, the insights gained from YpsoMate Zero inform the overall transition to zero carbon emission self-injection device platforms at Ypsomed. On the other hand, the YpsoMate Zero also reiterates the need to bring together the commitments of partners to achieve a net-zero carbon emission combination product.
Enabling the launch of a zero carbon footprint combination product by 2030 requires the involvement and co-ordination of multiple actors along the value chain in order to adopt the principles of the circular economy and remove its barriers to adoption. The journey to zero goes beyond Ypsomed’s own operations, products and services. To this end, the company is fostering collaborative problem solving, shaping regulatory frameworks and promoting the circular mindset with a science-based approach. Collaboration along the value chain will help Ypsomed to enable a zero carbon footprint combination product.