Leveraging stringency and lifecycle thinking to advance environmental sustainability in health technology regulation.

Alexander Cimprich, Gillian Parker, Fiona A Miller, Steven B Young

Abstract read

In one paragraph

Article in Health affairs scholar, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it

0cells of the map it votes in

0citing papers in PubMed

–field-weighted citation impact

1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Alexander CimprichSchool of Environment, Enterprise and Development, University of Waterloo, Ontario, Canada, N2L 3G1.ORCID https://orcid.org/0000-0002-0083-9709

Gillian ParkerInstitute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada, M5T 3M7.ORCID https://orcid.org/0000-0001-9884-9181

Fiona A MillerInstitute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada, M5T 3M7.ORCID https://orcid.org/0000-0003-4953-6255

Steven B YoungSchool of Environment, Enterprise and Development, University of Waterloo, Ontario, Canada, N2L 3G1.ORCID https://orcid.org/0000-0002-2235-725X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Regulatory actors, particularly market authorization agencies, health technology assessment agencies, and health care procurement agencies, exert a powerful influence on the adoption and use of health technologies (eg, medicines and medical devices). With health care being responsible, directly and indirectly, for an estimated 4.6% of global greenhouse gas emissions, alongside other environmental harms, these actors have recognized the need to address the environmental impacts of health technologies. In this commentary, we utilize concepts of regulatory stringency and lifecycle thinking, considering scope, prescriptiveness, and performance requirements, to analyze recent efforts to incorporate environmental sustainability into the regulation of medicines and medical devices. While we acknowledge recent progress, we argue that there is significant, untapped potential for developing more fulsome and effective regulatory mechanisms to improve the environmental sustainability of health technologies.

Indexed as

environmental sustainabilityhealth technologieslifecycle thinkingregulatory stringency

Identifiers

PMID39916971

DOI10.1093/haschl/qxaf017

PMCPMC11797384

What OpenQuestion holds

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LicenceCC BY-NC

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.