Pharmaceuticals Interest Group Open Meeting: Global Research and Regulatory Update

Pharmaceuticals Interest Group Open Meeting on Global Research and Regulatory Update

Tools addressing environmental impact of drug utilization – the role of pharmacoepidemiology

The WHO called climate change “the single biggest health threat facing humanity”. In industrialized countries, healthcare systems account for closer to 10% of national emissions, with prescription drug use being the third biggest contributor. Drug utilization is far from sustainable. Issues range from overuse and inappropriate use among prescribers and patients to stockpiling and inappropriate waste management. An increasing number of studies have shown traces of medicines in water from sewage treatment plants as well as in lakes and rivers across all continents. Pharmacoepidemiologists are equipped to address many of these issues. The recently formed Environmental Pharmacoepidemiology (EnvPE) SIG, research addresses the intersection among medications, medical devices, vaccines and environmental factors and influences. This webinar will focus on drug utilization and pharmaceutical waste, an important EnvPE area, addressing the following critical questions: How can pharmacoepidemiologists reduce the environmental and health burdens from pharmaceuticals? What pharmacoepidemiology method tools can be used? The presentations target different approaches how to assessing environmental aspects of drug utilization:

• Introduction to environmental pharmacoepidemiology and pharmaceutical waste
• The use of databases to promote and assess sustainable prescribing and use of drugs This presentation will show which opportunities and challenges there are to use existing registries on prescribing, dispensing and sales of medicines in studies of pharmaceuticals in the environment. How can these be used in promoting sustainable drug use?
• Opportunities with primary data collection in environmental research
  How can quantitative and qualitative surveys and interviews contribute to better understanding about pharmaceuticals in the environment and strategies forward?
• Integrating environmental sustainability with clinical appropriateness of drug use by a clinical and a regulatory point of view
  We will share possible strategies involving relevant stakeholders in containing environmental and health burden of medicines.
• Wastewater-based epidemiology - monitoring pharmaceuticals in sewage treatment plants, lakes and rivers
  How can analyses of human metabolic excretion products in wastewater and in the environment be analysed for a better understanding of the extent of the problem.
  The German Environment Agency (UBA) investigates the utility of non-target screening (NTS) portals in the detection of pharmaceutical mixtures and supports pharmaceutical legislation as well as Early Warning Systems. The German NTS portal, contains data on the aquatic environment from samples from the German Environmental Specimen Bank. Spatial and (retrospective) temporal trends of pharmaceuticals, highlighting ubiquitous exposure patterns and seasonal trends were analysed. The compilation of pharmaceutical screening lists also allows to study pharmaceutical mixtures. Quantified HRMS-NTS data, together with predicted no-effect concentrations (PNEC) enables the calculation of risk quotients and the identification of toxic drivers in the samples that can be used in prioritization.
• Panel-discussion
  The webinar will conclude by a panel-discussion on how pharmacoepidemiologists can promote a more “environmental-friendly” drug prescribing and use. The panel will address issues including availability of data, environmental hazard/risk, temporal relationship between drug use and environmental impact, and the value of these studies for decision-making.

The meeting will be held twice to accommodate different time zones. Another meeting will be held on 4 February from 17:00-19:30 CET.