By Deborah Borfitz

June 30, 2021 | Pharmaceutical leaders are being invited to join an emerging dialogue around ways to reduce the growing stream of electronic waste (e-waste) from digital health devices. The conversation has already been launched by some big-name players—Johnson & Johnson (J&J), Philips Electronics, the Waste Electrical and Electronic Equipment (WEEE) Forum, the United Nations Environment Programme, and the Copenhagen Business School among them—who agree on the need to holistically address the problem, according to Jason LaRoche, clinical innovation leader at Janssen Research and Development, a J&J company.

The subject will be tackled head-on during a panel discussion at SCOPE’s Clinical Research Leadership Forum, being presented virtually July 13-14 by the producers of the Summit for Clinical Ops Executives. On its own, Philips has already been making strides toward its goal to have 25% of its products be “circular” by 2025, as panelist Harald Tepper, Ph.D., senior director of group sustainability and lead of the company’s Circular Economy & Transformation program, will be able to share.

Products that are circular have reduced or eliminated the need for raw resources and have been designed with the end of their life in mind, LaRoche explains. They are part of the circular economy model seeking to design out waste and pollution, keep products and materials in use, and regenerate natural systems.

LaRoche says he would like to see a circular economy develop as part of the digital transformation healthcare is undergoing, where e-waste has been largely overlooked by companies, regulators, and users. The European Union (EU) would be an ideal starting point because member countries are already recycling-minded and their concern for the planet is remarkably evolved—the European Green Deal alone is pumping 1.8 trillion euros into its efforts to be the first climate-neutral continent.

“There is growing awareness that a healthy environment is key to a person’s clinical health,” LaRoche says. “We don’t want the benefits of digital health solutions to our treatments being offset by the negative environmental impacts they might cause.”

Urban Mining

Right now, almost nobody is thinking about what happens to the rising volume of wearable devices at the end of their useful life, he continues. “Last year alone, 83 million wearable devices were shipped to the EU market and that is expected to grow at a 12.4% compound annual growth rate over the next five years.”

If the trend continues, almost all of those 83 million devices are going to be in the waste stream by mid-2023 and the e-waste heap will be doubling every six years, LaRoche points out. One business-imperative reason to get ahead of the issue is to avoid fallout from an overly zealous regulatory response later that might hinder further use of wearables.

A preliminary analysis of a cross-section of wearable devices indicates that recovering just 70% of those 83 million devices, mirroring the recovery rate on general electronics in Europe, would free up about 108 million euros worth of raw materials, he says. In the mix would be almost 50 million euros worth of gold, 40 million in palladium, 9 million in silver, and 5 million in lithium.

“Urban mining” in this way could easily capture critical raw materials and at a fraction of the cost of mining gold out of the ground, LaRoche says. It also has potential geopolitical implications, particularly if Europe can lessen its dependency on other countries for lithium.

The circular economy around digital health devices that he envisions would feature innovators making products in creative ways and doing it locally against new, high-quality standards. These standards would address both the design and recovery of devices to stimulate circular thinking, he says.

Developing the technology, processes, and standards to enable products to be refurbished or remanufactured remains challenging, LaRoche continues. So, too, is figuring out how to get those devices back from their end users. Many healthcare companies have piloted collection schema to recover everything from used syringes to inhalers, but the volume of any one company’s products is generally too small to make the economics work.

Additional scale is needed for economic viability, and this presents one of the major opportunities for healthcare companies to collaborate, says LaRoche. A shared recovery program that covers a diverse array of products pooled across companies could provide the necessary volume.

Two-Pronged Approach

Through collaboration, it might be possible to both identify ways to optimize processes for recycling devices already on the market and develop design standards for products that have not yet been built so they can more readily be reused or remanufactured, says LaRoche. “Then, only when fully depleted of their usefulness would digital devices go into the recycling stream.”

One approach might be to have users mail back devices for remanufacturing once they are no longer needed. The process could be as straightforward as replacing a product’s battery and casing following each instance of use but reusing the electronics and core components for multiple remanufacturing cycles.

The creation of design standards would additionally allow med tech and pharma companies to collectively enhance their sustainability efforts, LaRoche says. If, for example, J&J and other pharma companies are all making auto-injectors on their own, they lose the opportunity to use common parts and drive economies of scale.

Having common parts would certainly make the devices easier to refurbish than trying to mix and match components during remanufacturing, he adds. It would also be easier to respond to changes in market demand if the devices had interoperable components.

Developing a circular economy for digital health devices will require a series of collaborative pilot projects throughout Europe and with partners from across the ecosystem, perhaps tapping national sources of public funding, says LaRoche. To scale the effort, multiple industry partners will be needed to pool their resources and distribute the upfront investment cost.

Reverse Logistics

Hospitals (particularly in Europe) have already started developing programs for dealing with medical waste, including electronic health devices, because they are top waste producers, LaRoche says. As one mastectomy patient recently shared via a video she posted online, all the disposables required for her surgery could cover an entire soccer pitch.

Beyond the technical challenges, there remains the issue of how to incentivize patients and customers to return their used products, LaRoche says. Various pharma companies are exploring returns processes involving mail-back or physical collection points that attempt to fit within the day-to-day routines of individuals—the end goal being to create the most frictionless method for end users to return the devices.

Maximizing return rates may require a combination of both the mail-back and physical collection point approaches, which may necessitate an “evolution of innovative reverse supply chains,” says LaRoche.  “We will need to develop a business model that will equitably distribute the value generated and ensure the economic viability of stakeholders.” 

Interested pharma companies should have no trouble finding a way to engage in e-waste reduction efforts with like-minded competitors, LaRoche says. Given the complexity of the problem, they would have ample latitude to “pick and choose” which piece of the puzzle they wanted to solve.

Editor’s Note: Panelists for the “Addressing the Emerging Challenge of Digital Health Waste” session that Jason LaRoche is moderating at SCOPE’s Clinical Research Leadership Forum are James Horne, project manager for the WEEE Forum; Feng Wang, program officer for the United Nations Environment Programme; Harald Tepper, leader of the Circular Economy & Transformation program at Philips; and Daniel Fuerstenau, assistant professor of digitalization at the Copenhagen Business School.