Sustainability is a big-ticket agenda item within the healthcare industry. This is hardly surprising: globally, the healthcare industry is estimated to contribute 4.4% of global net emissions, per the British Medical Journal. But beneath that headline-making figure, there is a more specific sector-wide conundrum to be solved: the use of plastic packaging.
This year, plastic use in the sector is estimated to hit around 24 million tonnes, as noted by the Healthcare Plastic Recycling Council (HPRC). Plastic is flexible, sterile and durable. It makes perfect sense that it is used to package everything from blister packs and injection vials to the essential packaging protecting IV drips before use.
As Sharon Barak, CEO of Solutum – a business that supplies sustainable alternatives to single-use plastics for healthcare clients – puts it: plastic has been a boon to the healthcare industry. “And it’s everywhere in pharmaceuticals,” she adds.
However, this poses a sustainability problem. Across Europe, Healthcare Without Harm statistics show that 36% of all healthcare waste is from plastic use. One study on the use of plastic in a single Dutch hospital, cited by the UK Research and Innovation governmental body, found that 50% of all plastic waste was from packaging alone, while roughly half of that waste didn’t have labels identifying the polymers it derived from, creating follow-on difficulties for disposing of the device sustainably.
Yet those who want to improve sustainability in healthcare packaging face a multitude of barriers. That includes the scale of the challenge but also the price. “Everyone wants greener material [more sustainable packaging] but no one wants to pay for it,” says Barak. “So suppliers have to be both cost-effective and environmentally friendly, which is a challenge.”
In addition, any redesign of packaging – at least for medical devices and medicines that require sterilisation – also has to adhere to strict regulations, such as ISO 11607, set by the International Organisation of Standardisation. Plus, the packaging still needs to do its primary job: guaranteeing protection and ease of use of the product.
Appetite for change
Notwithstanding such difficulties, the industry is taking sustainability in packaging seriously. Barak explains how efforts are expanding: first from cardboard use in packaging to focus on plastic. “Before we were involved, everything [all other materials in packaging] was sustainable apart from the plastic,” she explains.
Broadly, sustainability efforts are directed at the institutional level. In the UK, the NHS, back in 2019, identified the need to reduce single-use plastics across the entire supply chain. In 2024, the EU adopted new rules around plastic packaging waste, including reducing unused space in packaging and moving towards an eventual ban on single-use plastics in packaging.
As such, the industry is stepping up. Sanofi recently moved one of its vaccines into plastic-free cardboard packaging, reducing plastic use by 130t in 2023. AstraZeneca also moved from single-use boxes in clinical trial products to reusable packaging, resulting in a 98% return and reuse rate of said boxes.
Elsewhere, Smith + Nephew has moved towards sourcing materials for its packaging from responsibly-managed forests and adding more recycled content into its packaging materials. For one of the England-headquartered firm’s foam dressing products, within the most packagingintense side of the business, there was a recent redesign of packaging to be up to 46% smaller, taking down CO2 emissions by 193t.
Barak, for her part, certainly feels that there’s an appetite to do better all over the market. “While we are only doing the flexible plastics [film coating for medical boxes] we have been approached for [more sustainable] blister packaging too,” she says.
24 million tonnes
The sector’s estimated annual plastic use.
Healthcare Plastic Recycling Council (HPRC)
Simulating solutions
But sustainable packaging must still meet both customer and regulators’ needs. As Camilla Enkbridge, chief technology officer at medical and pharmaceutical packaging solutions provider Envirotainer, explains, the design stage of packaging is critical in addressing these demands while ensuring sustainability.
Indeed, a 2024 Waste Management study found that understanding the whole packaging life cycle at the design stage – inclusive of materials choice to dimensions – can help improve sustainability efforts. For instance, designing materials with lower production impacts, such as using PVC-Alu for blister packs.
However, the design process itself can be timeintensive. In a recent European Pharmaceutical Manufacturer article, a manager at the International Federation of Pharmaceutical Manufacturers and Associations described how changing packaging requires the need for new studies and guarantees of sterility within stringent regulatory conditions. This can slow down the speed to market.
Some in the field, including Envirotainer, have turned to simulation analysis, or simulation testing, as a possible solution. This is software that allows different packaging designs to be evaluated without needing to create a physical prototype.
“Simulation plays an important role in developing our solutions,” explains Enkbridge. “By utilising [simulation] we can shorten our development time and faster adapt to changes optimising the performance.” She notes that simulation can use past data to predict packaging outcomes, such as how specific elements in the packaging might perform or how it responds to different environments. “Multiple simulations analyse different aspects of how different building blocks in our solutions impact the performance under different conditions.”
Nic Hunt, executive committee member of the HPRC, penned a Medical Plastics article in agreement. Here, he wrote, simulation might allow better outcomes by signposting opportunities for material reduction or design reconfiguration. “This not only accelerates the design process but also minimises resource consumption and waste generation associated with traditional trial-anderror methods,” he wrote. The subtext: fewer mistakes, less waste, lower cost.
As Hunt argues, simulations allow for improved scenario testing and sensitivity analysis, simulating real-world conditions and stressors to ensure sustainability but also reliability and performance. This addresses not only the design of the packaging itself but how it responds to transportation, storage and end-of-life scenarios, to further improve sustainability across its life cycle.
All without extensive physical prototyping, which can create further waste products.
Greener futures
The industry appears to be with Hunt. Since the mid-2010s, AstraZeneca has moved from physical prototyping to using 3D simulation to look at 360º mock-ups. This brings benefits for speed-to-market and, of course, curtails use of physical prototypes that are less environmentally friendly.
Bausch + Stroebel, serving packaging production needs for multiple pharmaceutical businesses, also moved from physical prototyping of production lines and packaging processes to simulation a decade ago. Not only does this promote sustainability but, as the German-headquartered firm claims, has boosted customer satisfaction: 98% of its clients claim simulation is a better approach than having physical mock-ups.
Elsewhere, according to Visual Components, a company that develops simulation software for pharmaceutical clients, design mistakes can be costly as pharmaceutical packaging plants rely on quick process times and high yields. The Finnish designers claim that with pre-made components in their simulation libraries, mistakes can be avoided – all while boosting efficiency, too.
Yet simulation technology is still advancing. Building on data from previous designs, Enkbridge says her business is looking at AI-based tools to “further categorise, learn and develop our system”. It’s an AI-enabled approach to simulation that is claimed can further speed up processes, so designers don’t have to start from scratch when changing variants while mock-ups for any change can be delivered within seconds. Dassault Systèmes, which provides such virtual tools for firms such as packaging giant RETAL and cosmetics and well-being brand L’Oreal, is already championing this approach.
At Envirotainer, the move towards AI in simulation fits with their expansion of R&D efforts to deliver improved reliability and assess how packaging performs in more “extreme conditions”. This is especially important in our changing world, not least in meeting evolving sustainability regulations. “An increasing focus on sustainability in the industry in recent years means we take it into consideration when developing our solutions,” says Enkbridge.
But even as it’s used today, simulation can drive clear results. One example is Envirotainer’s Releve product, which is packaging that maintains a specific temperature for a sustained period of time and was designed to be used multiple times. During the design phase, simulation analysis helped the team to make it lighter and more volume efficient. And ultimately, the resulting product was more sustainable.
However, reliability and meeting both regulatory and client needs factor in, too: green success metrics must sit alongside those for cost and usability. And Envirotainer has indicated that these factors don’t have to be mutually exclusive.
36%
The percentage of healthcare waste from plastic use across Europe.
Healthcare Without Harm
Last year, the firm won awards for providing the most diverse range of packaging while sales turnover doubled from 2017 to 2023. In 2022, while shipping 19% more medicines than in the previous year, the firm claims to have added no extra CO2 emissions. As Enkbridge says: “[If the] packaging solution can have an impact on sustainability goals… that with cost, efficiency and protecting patient safety really can go hand in hand.”
Results that, truly, can’t be simulated.
