As climate change continues to affect the world, industries are challenged to adopt more environmentally friendly practices. And the healthcare industry is no exception. In fact, hospitals alone generate over 5 million tons of waste each year.
But there are ways to help turn the tide. By creating more sustainable healthcare products and solutions, healthcare companies can reduce their environmental impact while continuing to provide the best care for patients.
“We know that the products that support patient health may have environmental impacts after they’re used,” says Daniel Unger, Environmental Sustainability Manager, Johnson & Johnson MedTech Germany. “There is a great opportunity to support new recycling and closed-loop processes so we can help reduce waste and keep valuable materials in use longer.”
Johnson & Johnson has long championed sustainability—it even added its responsibility of “protecting the environment and natural resources” into Our Credo, the company’s mission statement, in the 1970s. More recently, in its 2022 Health for Humanity Report, which details Johnson & Johnson’s environmental, social and governance progress, the company outlines its accomplishments in sustainable products and solutions in healthcare. These accomplishments are driving Johnson & Johnson closer to its Health for Humanity 2025 Goals: to champion global health equality, empower its employees, lead with accountability and innovation and advance environmental health.
Below are three initiatives that are paving the way for sustainability in healthcare around the world. The through line for all of these programs? A dedication to patient care, commitment to a circular economy (that is, a system based on reusing materials) and the innovation and forward-thinking that is a hallmark of the company.
1.
In hospitals, single-use medical instruments (which can include needles, surgical instruments, catheters and endoscopes) are used once per patient and then disposed of—eliminating the potential for cross-contamination from patient to patient and reducing time spent on cleaning and sterilizing.
But since they’re also sent straight to landfills or incinerators after use, these items can create a large amount of waste each day.
Johnson & Johnson’s single-use medical device recycling program is aiming to change that.
In 2021 and 2022, components from more than 25,000 single-use products were recycled through Johnson & Johnson’s program—and numbers are expected to grow.
The program, which started in New Zealand in 2018 and then piloted in Germany in 2020, allows hospitals to recycle specific metal and plastic components from some Johnson & Johnson MedTech single-use instruments, as well as absorbable suture aluminum-based packaging.
“Many surgeons and nurses were seeing the impact of single-use instruments on the environment and were also concerned about the valuable materials they’re made of, which were being used once and discarded,” says Unger, who helped develop the recycling program in Germany. For him and his team, the question was: Can we treat these devices differently and is it feasible?
They have proven that the answer is yes. Thanks to this program—which has expanded to Switzerland, the Netherlands, Norway, Belgium, Sweden, the UK and Austria with plans to expand further—some highly valuable materials such as surgical steel, aluminum and chrome, as well as specific plastics, can be recycled, keeping them in the circular economy where these materials can be used to create new non-medical products. “We started the program in Europe focusing on two Johnson & Johnson MedTech products, and continue to add more products to recycle,” Unger says.
Hospitals are also digitally capturing and communicating the environmental impact of salvaging these materials: In 2021 and 2022, components from more than 25,000 single-use products were recycled through the program—and the numbers are expected to grow as more hospitals participate in this program.
Recycling these single-use medical devices not only lightens the load at incinerators and landfills and repurposes valuable materials, it also saves hospitals from spending money on waste-removal fees.
Beyond recycling medical devices, Unger is working with other teams to explore how to incorporate sustainable practices into product design. “We need to revise how we design a product so that less waste is produced during the beginning of its life cycle,” he continues. “Expectations are getting higher and higher, and our aim is to provide customers with more environmentally friendly products when possible.”
2.
As technology evolves, digital health devices—such as wearable sensors used in home care settings, smart pillboxes and e-labels that replace paper labels on medication kits in clinical research—will increasingly become a standard part of healthcare. In fact, the use of digital health devices is predicted to rise rapidly over the next five years, with expected annual global growth rates of almost 20% by 2027.
But as these devices become increasingly ubiquitous, so too will the problem of how to discard them at the end of their life cycle.
“There are many potential benefits to using medical wearables, including better patient comfort and ease of treatment,” says Els Ducheyne, Senior Manager of Material Compliance & EPR, Janssen. “But these wearables introduce an increasingly large e-waste problem, with additional complexity since they may contain a needle or remnants of a drug, or they may have been in contact with infectious disease.” For these reasons, medical wearables can’t go into normal waste streams.
That’s why Johnson & Johnson led the launch of the Digital Health in a Circular Economy (DiCE) collaborative initiative last year, with Ducheyne as the coordinator.
DiCE brings together 20 organizations from nine European countries with expertise in manufacturing, research, refurbishing, remanufacturing, recycling, social science and policy. The collaborative, which received co-funding through the European Union, considers every point in the life cycle of digital health devices to identify opportunities to extend the use of these products and responsibly dispose of them.
Ducheyne says the collaboration of team members from different disciplines is the secret to the success of DiCE. “A lot of projects are usually tech-driven, but a big key to the success of this project is getting patients to return devices,” she says. “We can design all the reverse-manufacture technology that we want, but if we don’t get devices back, it won’t work. So within the consortium, we also built in behavioral science.”
DiCE aims to produce a replicable model for reuse, refurbishment and responsible disposal that can be adopted across the entire digital healthcare industry—and beyond.
3.
The Safe Returns program kicked off more than a decade ago in the U.S. with a simple plan: to make it safe and convenient for patients using self-injectable devices at home to return them.
The early iteration of Safe Returns relied on disposing devices in bulky plastic disposal jugs and large cardboard boxes and required trips to the patient’s local post office, explains Lori Monaghan, Director of Customer Focused Innovation, Janssen Supply Chain Strategy & Deployment. Today, the program utilizes slim 5"x9" paper envelopes—introduced in 2021—for patient returns, which their local postal carrier can pick up.
“It’s a cleaner, simpler process for patients,” Monaghan explains. Plus, it “gets away from all those cardboard materials and plastics from the previous return model.”
The Safe Returns team conducted robust testing for both devices and the return envelopes. In doing so, they redesigned not only the disposal process but the devices themselves to make the return process more seamless. “We conducted extensive testing of the self-injectable devices with the new envelopes, which ultimately led us to reclassify the devices so that they are no longer considered a ‘sharp’ or a biohazard,” Monaghan says. That opened the possibility for more return options.
After refining the Safe Returns program in the U.S., the team took it global. “Switzerland was our first pilot program, and we launched in April 2022 with training, a call center and an innovative digital platform that provides information for patients,” says Monaghan.
The program was implemented in Norway earlier this year, and there are plans to launch in Austria, the UK and Ireland in the near future.
But Monaghan says expanding the Safe Returns program is just the beginning. “We want to enable device circularity,” she says, meaning they want to repurpose the used devices as new medical devices. “Currently, all of this waste collected through Safe Returns is incinerated. We are building a disassembly unit that we hope to have in play by early next year to deconstruct the used devices. Once that unit is live, we’ll be able to separate out plastic, glass and metal, which can be sent to recycling partners.”
The ultimate goal? To form a consortium of other players in the pharmaceutical industry. “We are excited to lead and pioneer,” Monaghan says. “Taking this industry-wide will allow us to build more disassembly units, and then the goal is to work with doctor’s offices and hospitals to achieve device circularity there, too.” Indeed, a win for both patients and for the planet.
