A disposable insulin pen changed Brian Blundell’s life.
Growing up with type 1 diabetes in the 1970s, he had to carry glass syringes and vials of insulin with him everywhere he went. So in 1985, when Novo’s Nordisk introduced his pen, a disposable prefilled drug that combines several doses of medication in a syringe, Blundell quickly adopted the new device.
“They were a godsend,” he recalled.
But recently, he’s started weighing the impact of the plastic in the pens he’s been throwing away over the years against the potential harm they cause to people and their surroundings.
“I use this life-saving product,” he said, irritated. “But to use it, you have to be prepared to destroy the environment.”
It’s no secret that the world has a plastic problem. Versatile, durable, and inexpensive, this material is clogging the world’s oceans, leaching toxins into biomes, and contributing to climate change. Some countries are drafting a proposed treaty that could ban some single-use products and set goals to reduce plastic production around the world. However, negotiations have stalled due to opposition from the fossil fuel and chemical industries.
The global healthcare industry is expected to use more than 24 billion pounds of plastic in 2023 and generate 38 billion pounds annually by 2028, according to global market research firm BCC Research.
Plastics, which are typically manufactured from fossil fuels, are also a major source of greenhouse gas emissions. In the United States, the healthcare sector accounts for 8% of the country’s carbon dioxide emissions.
Medical device companies say they are working to reduce waste by collecting and recycling products, reducing the amount of plastic in devices and packaging, and redesigning products with non-petroleum-based materials.
For the average person, the most visible medical debris is disposable equipment used in the home, from respiratory inhalers to syringes, tampon applicators, oxygen masks and tubing.
Mitch Ratcliffe, publisher of Earth911, a website with a vast database of U.S. recycling facilities, said there is little hope of recycling these items at this point. This is in part because of their irregular size, safety concerns that non-sterile elements can spread disease, and because they are often constructed of materials that cannot be processed together. “Our economy is full of intricately designed things, and it’s incredibly complex. I never thought about taking it apart again.”
Few devices are as popular as insulin pens. According to the Centers for Disease Control and Prevention, about one-third of the 37 million Americans with diabetes manage their disease with insulin.
Novo Nordisk alone produced 750 million insulin pens made from more than 28 million pounds of plastic in 2021. The pen contains a glass bottle inside a plastic frame and is not designed to be disassembled into parts for recycling. Almost all of it is considered household waste.
Blundell of Oregon City is trying to do something with discarded devices. A biomedical engineer, he spent his career developing pacemakers, defibrillators, and catheters. Semi-retired in 2021, he and his partner designed a handheld gadget that can cleanly cut and disassemble insulin pens. He’s also working on a plastic dispenser for Ozempic, a diabetes drug now taken by millions of people to lose weight.
But Blundell acknowledged that dismantling the cages is just the first step. Although the pen’s plastic is of high quality, it is not the type that can easily be disposed of at municipal recycling sites. It could end up in a landfill or incinerator, perhaps bundled together with other plastics.
He’s also exploring whether his gadgets, which are also made of plastic, could be made from bamboo or other sustainable materials. “It’s pretty hard to sell someone on the idea of wanting them to buy this plastic equipment to save plastic,” he says.
Global biomedical giants are facing increasing public pressure to change the life cycles of their products. Novo He said Nordisk plans to redesign its products to achieve a net-zero emissions goal by 2045.
This is a change from the company’s history, when disposable items were a desirable convenience. “No one thought about designing for circularity, considering what materials should be used, or limiting the thickness of plastic,” said Catherine Dibona, the company’s vice president.
In 2020, the company launched a program to recycle used insulin pens in three Danish cities. We provided pharmacists with collection bags to hand out to patients picking up prescriptions, allowing patients to return used devices at their next appointment. A third-party recycling company then collected the pens for disassembly, sterilization, and processing.
Novo Nordisk has since expanded the program nationally and opened it up to competitors, launching pilots in the UK, France and Brazil. But changing public behavior is difficult. By the end of 2023, only 21 percent of the company’s pen users in Denmark had returned their devices.
GSK, which sells more than 200 million respiratory inhalers a year, encountered similar problems with its device recall program in the UK between 2011 and 2020. While the plastic parts of inhalers can be recycled through most in-store collection programs, the aluminum canister that contains the medication is not. So the company collected used equipment from pharmacies, recycled what parts it could, and incinerated the rest.
However, the program did not garner much interest from consumers. Over nine years, only 24,000 pounds of plastic was recovered from the inhalers, said Clare Rand, the company’s vice president of sustainability, compared to the roughly 5 million pounds of plastic needed each year to make the inhalers. “It’s a very small amount,” he said.
Of more concern to environmentalists are the propellants in many inhalers, which are typically more powerful fluorinated gases that cause more global warming than carbon dioxide. In 2021, GSK began developing an alternative, which Lund suggested could significantly reduce carbon emissions.
However, the company is still testing new formulations and expects it will take years to win approval for a replacement in the 140 markets where the existing formulation is sold.
Lund said the company was looking at creating reusable products. “I’ve been on the table many times and been pushed back,” she says.
In contrast to Novo Nordisk’s boutique focus on recovering materials from specific products, US waste management company Triumvirate Environmental is focusing on the commercial use of recycled medical waste. I’m looking for.
In 2014, the company bought a machine from a plastic lumber company and transplanted it to the back of a medical waste processing facility in Janet, Pennsylvania, with the idea of turning some of the waste into useful products.
The company’s CEO, John McQuillan, said the $70 million factory takes in waste from hospitals and pharmaceutical companies – “some of the most disgusting stuff on the planet” – and processes it through complex equipment. He said it was being processed. of the machine.
Much of the waste is still incinerated, but items made of useful plastics, such as containers filled with syringes and surgical instruments wrapped in packaging, are identified, shredded and converted into building materials. .
“It’s like stinky Willy Wonka,” he said.
Triumvirate recovers some of its costs from the sale of the final product, but McQuillan estimates the process is six to eight times more expensive than bulldozing the waste into a hole in the ground. .
There is no lack of interest from medical companies, which produce far more plastic waste than the triumvirate’s factories can handle. Rather, the speed-limiting factor is the demand for the structural plastic wood they produce, which must be practical and competitive with alternatives made from cheaper plastics. “Any color is fine as long as it’s black, and you have a pretty liberal definition of black,” McQuillan says.
Still, Triumvirate sold the material for £12 million in 2022, including to Menards and Home Depot, where it sells it for landscaping and as lawn underlayment.
Like most recycling, this process is also energy-intensive. The plant receives plastic waste primarily from customers in the northeastern United States, because the material tends to be loosely packaged and is expensive to transport long distances.
Scientists say this energy expenditure eliminates most of the environmental benefits. According to Dr. Andrea McNeil, founder of the Planetary Healthcare Lab at the University of British Columbia, most of a product’s environmental impact occurs during its production, so the carbon footprint that can be recovered by recycling a product is small. is usually less than 10%. “We are never going to recycle for a healthy planet,” she said.
It’s far more important for manufacturers to design products that can be reused for years, he said, adding that this will also require a change in business models. “Right now, profit margins are dependent on mass consumption.”
The next advancement in sustainable medical device design may occur in the chunky brick-and-glass headquarters of Battelle, a nonprofit research and development organization in Columbus, Ohio. The organization primarily handles long-standing projects for the U.S. military and Department of Energy, but hundreds of staff also work with name-brand medical companies on product redesigns.
The medical equipment team controls an entire floor of one building. Some local scientists are trying to turn soybeans into a usable alternative to traditional petroleum-based plastics. Some researchers are using large stainless steel reactors to study how substances break down.
Erik Edwards, one of Battelle’s lead materials scientists, said the Food and Drug Administration’s review process for new devices has led his team to tweak existing products rather than propose wholesale changes. said. For example, we are helping pharmaceutical companies redesign their insulin devices by removing a single single-use plastic component. “The approach you take is like a thousand small steps,” he said.
He said packaging improvements could be easily achieved. A few years ago, the lab received an order for palm-sized medical equipment that arrived in boxes that were several pallets worth. “These air shipments were happening because they needed more space for packaging than they needed,” he recalled.
Edwards said Battelle’s customers generally favor changes aimed at reducing costs or improving performance, but sustainability is becoming a more important factor.
Mechanical engineer Grace Lilly likened this evolution to changes in the way milk is sold over time. While people used to collect glass bottles from their doorsteps and return the empty bottles for reuse, the introduction of single-use plastic water jugs has eliminated the milkman profession. Reducing dependence on plastics may mean bringing back some processes and roles.
“You might want people to do something different, but then you have to adjust to the culture,” she said.
