Patient preferences and attitudes regarding the environmental impact of medicines: A discrete choice experiment

AIMS: Pharmaceutical utilization within global healthcare has significant environmental impact throughout its lifecycle. Understanding how the environmental impact of medicines influences patients' preferences relative to ease of use and cost supports interventions promoting appropriate medicine consumption, reduced waste and environmental sustainability. The aim of this study was to investigate patient preferences and attitudes regarding the environmental impact of medicines in relation to ease of use and cost.

METHODS: A cross-sectional survey (December 2022 to January 2023) was conducted using the Dutch AMP pharmacy panel (>25 000 chronic medicine users). It included a discrete choice experiment (DCE) on medicines' environmental impact, ease of use and cost, and questions on environmental sustainability in medicine use and daily life. Latent class analysis identified groups with shared preferences. An environmental sustainability attitude score was calculated from daily life behaviour.

RESULTS: Of 25 787 invited panel members 6390 responded and 4122 were included in the analysis (16.0%, mean age 68 years, 42.6% female). Four preference groups were identified and labelled based on DCE-derived attribute preferences: eco-focused (55.7%), cost-focused (20.1%), indifferent (16.4%) and eco-sceptical (7.8%). Environmental sustainability attitude scores were highest in the eco-focused and eco-sceptical (median 75.0%) groups, followed by the indifferent and cost-focused (median 66.7%) groups. Important factors influencing this were environmental concerns (eco-focused), environmental and personal health concerns (eco-sceptical), costs (cost-focused) and environmental, cost and personal health concerns (indifferent). Only 8.8-15.5% reported good or very good self-assessed knowledge of medicines' environmental impact.

CONCLUSIONS: Environmental sustainability significantly affects medicine preferences, although heterogeneity exists. Tailored initiatives are required to promote environmentally sustainable pharmaceutical care.