Anne Gadegaard, Global Senior Advisor of Novo Nordisk has delivered a presentation on 11 May 2016 at the dialogue on “Fostering Sustainable Procurement: How Procurers Can Change the Global Health Sector” in UN City, Copenhagen.

1. Introducing the
Coalition for
Sustainable
Pharmaceuticals
and Medical Devices
Anne Gadegaard
Global senior advisor
Novo Nordisk A/S

2. The road towards the CSPM
• Action was needed to reduce GHG emissions of
pharmaceuticals and medical devices
• A consortium with suppliers was formed by the
NHS SDU
• Purpose was to collaborate to reduce GHG
emissions
• Milestones so far:
• 2011: Convened suppliers (initial with 6 multinationals)
• 2012: Published first GHG guidance on products
• 2013: Formed CSPM
• 2014: Published top 20 GHG intensive pharmaceuticals
• 2015: Published second guidance on care pathways
• 2016 projects
1. Sustainable procurement
2. Case studies
3. Tools and training
CSPM - Fostering Sustainable Procurement 11 May 2016 2
More information: www.sduhealth.org.uk/cspm

3. Aim
• Acting as the convenor of expertise related to sustainable pharmaceuticals
and medicals devices and disseminate best practise throughout the
healthcare system globally
• Developing tools and guidelines to support the system in achieving more
sustainable healthcare products and services through a holistic life cycle
sustainability approach
• Monitoring and updating existing tools and guidelines developed by the
coalition to ensure their applicability (eg carbon footprint guidance)
Success factors
• Equal partnership, open and transparent, mutually beneficial, share
environmental improvements
CSPM aim
CSPM - Fostering Sustainable Procurement 11 May 2016 3

4. GHG guidance on products
• No consensus on consistently
quantifying GHG emissions of
pharmaceuticals and medical
devices
• Need to drive GHG reductions
and measure achievements
• Aim
• Support consistent
quantification of the
carbon footprint of
pharmaceuticals and
medical devices
• Enable understanding of
GHG hotspots to identify
reductions
• Encourage public
reporting of product GHG
emissions
• Users
• Producers within the
sector or value chain
• Healthcare services /
regulators /policy makers
• Procurement teams
• Content
• What to include/exclude
across product life cycle
• How and where to collect
information
• Definitions and life cycle
diagrams
CSPM - Fostering Sustainable Procurement 11 May 2016 4

5. Top 20 GHG intensive pharmaceuticals
• Pharmaceuticals
contribute 11% to NHS
carbon footprint but
which pharmaceuticals
contribute the most is
unknown
• Aim
• Identify a priority list of
pharmaceuticals based on
GHG contribution
• Work with suppliers to
better understand carbon
footprint of
top 20 products and
identify reduction
opportunities
• Collect GHG data to
improve accuracy of NHS
carbon footprint
CSPM - Fostering Sustainable Procurement 11 May 2016 5

6. Care pathways
• Aim
• To understand
environmental impacts of
services and
how products are used
• Support NHS five year
forward view
• Promote prevention and
enhance service redesign
• Freely available guidance
allowing interested parties to
investigate and understand
the sustainability aspects
of healthcare pathways
globally
• Enable sustainability
considerations to be more
easily
taken into account in a
transforming global
healthcare
system
CSPM - Fostering Sustainable Procurement 11 May 2016 6
Optimise
existing
care
pathways
Design
new
sustainable
care
pathways

7. Initial six modules
Data included
• Consumables and equipment
• Pharmaceuticals and medical gases
• Building energy, water and waste
• Staff, patient and visitor travel
CSPM - Fostering Sustainable Procurement 11 May 2016 7
Inpatient Bed Day
Surgical
Procedure Self ManagementGP Consultation Patient Travel
Emergency
Department Visit
Environmental impacts considered
• GHG emissions
• Fresh water use
• Waste generated

8. Module GHG hotspots - where to target
CSPM - Fostering Sustainable Procurement 11 May 2016 8
Consumables
Equipment
Medicalgases
Transport
Energy
GHGemissions
fromwaste
Total
1. GP consultation 26% 0% 12% 59% 3% 100%
2. Patient travel (GP & elective care) 100% 100%
2. Non emergency provided patient travel 10% 7% 13% 55% 15% 0% 100%
2. Emergency provided patient travel 6% 8% 10% 59% 17% 0% 100%
3. Emergency department visit 6% 2% 15% 6% 70% 0% 100%
4. Low intensity inpatient 39% 4% 5% 10% 40% 1% 100%
4. High intensity inpatient 16% 4% 4% 5% 68% 2% 100%
5. Surgical procedure 22% 3% 31% 3% 40% 0% 100%
6. Self management education session 24% 3% 35% 38% 0% 100%
Carbon footprint
contribution to
healthcare activities

9. • Anne Gadegaard, Global senior advisor, Corporate Sustainability, Novo Nordisk A/S, AGLn@novonordisk.com
• Tom Penny, Product Sustainability Lead, NHS Sustainable Development Unit, tom.penny@nhs.net
• CSPM website: http://www.sduhealth.org.uk/cspm
• GHG Protocol Accounting Guidance for Pharmaceuticals and Medical Devices
http://www.ghgprotocol.org/Guidance-Built-on-GHG-Protocol
http://www.sduhealth.org.uk/areas-of-focus/carbon-hotspots/pharmaceuticals/cspm/carbon-footprint-guidance.aspx
Identifying GHG Intensive Pharmaceuticals in NHS in England
http://www.sduhealth.org.uk/documents/publications/2014/GHG_Prescription_Feb_2014.pdf
• Assessing Environmental Impacts of Care Pathways
http://www.sduhealth.org.uk/areas-of-focus/carbon-hotspots/pharmaceuticals/cspm/sustainable-care-pathways-
guidance.aspx
• Lifelong Type 2 Diabetes Management Care Pathway
http://www.sduhealth.org.uk/areas-of-focus/carbon-hotspots/pharmaceuticals/cspm/case-studies.aspx
• Expanding Health Technology Assessments to Include Effects on the Environment,” published online in Value in Health,
January 2016
• http://www.valueinhealthjournal.com/article/S1098-3015(15)05128-1/abstract
Further information
CSPM - Fostering Sustainable Procurement 11 May 2016 9