Environmental and Financial Cost Savings With Low-Consumption Intravitreal Injection Techniques.

Area of Science:

• Ophthalmology
• Environmental Science
• Health Economics

Background:

• Intravitreal injections of anti-VEGF therapies are standard treatments for various eye conditions.
• The financial and environmental footprint of medical supplies used in these procedures is substantial.
• Optimizing supply chains and procedural protocols is crucial for sustainable healthcare.

Purpose of the Study:

• To quantify the financial costs associated with medical supplies for anti-VEGF intravitreal injections.
• To assess the environmental impact, measured in carbon dioxide equivalents, of these supplies.
• To compare different procedural protocols and their respective resource consumption.

Main Methods:

• Life cycle assessment (LCA) was performed on all supplies for bevacizumab, aflibercept, and faricimab injections.
• Two LCA models were employed: a process-based approach and a hybrid LCA with an economic input-output model.
• Data on supply weight, material composition, and retail price were collected and analyzed across three distinct procedural protocols.

Main Results:

• Excluding medication, procedural costs ranged from $12.05 to $88.69, with environmental impacts from 3 to 20 kg CO2 equivalents per protocol.
• National extrapolation suggests annual material costs nearing $27 billion and over 7.2 million metric tons of CO2 equivalents for 15 million injections.
• Adopting the least resource-intensive protocol (protocol 1) could save over 800 tons of waste, $500 million, and 120,000 metric tons of CO2 equivalents annually.

Conclusions:

• Minimizing supply consumption during intravitreal injections offers significant financial and environmental benefits.
• Procedural modifications, such as omitting speculums, calipers, or sterile gloves, can lead to substantial reductions.
• Sustainable practices in ophthalmic procedures are essential for reducing healthcare's ecological burden.