ReviewCanadian family physician Medecin de famille canadien2025
Journey of a pill.
Review in Canadian family physician Medecin de famille canadien, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 5 papers.
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.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
5 citing papers in PubMed.
- Applying Abstract Text Mining as a Complement to PRISMA in Reviewing the Scope of Healthcare's Circular Economy Comment on "A Review of the Applicability of Current Green Practices in Healthcare Facilities".International journal of health policy and management · 2026Article
- Ethics and action pathways for psychologists in a time of climate crisis.Frontiers in psychology · 2026Review
- Correction.Canadian family physician Medecin de famille canadien · 2025Article
- The environmental elephant in the office: medications.Canadian family physician Medecin de famille canadien · 2025Article
- The more things change, the more they stay the same.Canadian family physician Medecin de famille canadien · 2025Article
Corrections and comments
- Erratum issuedCorrection.2025
Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo estimate the global journey of a generic clonazepam pill to map steps of production, distribution, and disposal. DATA SOURCES: PubMed; Google Scholar; industry and market reports; gray literature; pharmaceutical databases (eg, PharmaCompass); export records; pharmacies in Hamilton, Ont; industry professionals and leaders such as pharmaceutical company vice presidents, professors, a supply chain insurance company, and sustainable procurement consulting companies; and an international not-for-profit company. STUDY SELECTION: Data related to clonazepam's standard pharmaceutical production process, life cycle system boundaries, and most probable production locations were included in this review. SYNTHESIS: This study depicts the estimated journey of a clonazepam pill's production and distribution, with the prescription being filled in Vancouver, BC. It begins with the extraction of salts to produce the active pharmaceutical ingredient. The main centres for clonazepam's active pharmaceutical ingredient and excipient salt extraction and production are in India and China. Quality testing and stocking occur elsewhere, such as within the European Union. The product is then shipped back to India for the next manufacturing stages. Excipients are shipped from China to India and are incorporated into formulation and tableting. The product is then sent to global markets for the final stages of pill formation and regional distribution. After shipment through Europe and Asia, the journey continues through several locations within the United States, specifically New Jersey, for the final stages of manufacturing. Once manufacturing is finalized in New Jersey, the pill is shipped to and repackaged in Tennessee for distribution and then sent to Canadian industry clusters, typically within the greater Toronto area in Ontario. Pills are then shipped to pharmacies and hospitals in Vancouver, BC, for consumer use. The total distance travelled in this scenario is approximately 63,162 km, not including the entire process of producing and shipping excipients or local retailer shipments.
conclusionHealth care prescribing practices have tangible environmental impacts and manufacturers should continue to invest in operational streamlining to reduce greenhouse gas emissions.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.