Study: Many medicine users prefer sustainable options, even if they cost more

Many patients would prefer to use medicines that are less harmful to the environment, even if that means paying more or compromising on convenience. That’s the key finding from new research by Utrecht University, led by pharmacist and researcher Milad Sadreghaemy. His team advocates for better education on this topic so patients can make informed decisions and become more aware of waste and health care costs.

The study, published in the British Journal of Clinical Pharmacology, found that more than half of respondents would rather choose a medicine that is environmentally friendly, even if it’s more expensive or less convenient.

At the same time, patients vary widely in how they weigh these factors, and many admit to having limited knowledge about the environmental effects of medicines.

“What really surprised me,” says Milad Sadreghaemy, “is that many people care about sustainability in everyday life, but don’t think about it when it comes to medicines. That disconnect is exactly what we want to highlight with this study.”

In the study, participants were repeatedly asked to choose between two fictional medicines. Each pair of medicines was identical in terms of effectiveness and side effects. But they differed in price, ease of use, and environmental impact. A large group consistently chose the more sustainable option, even if it meant sacrificing convenience or affordability. Yet only a small number of participants said they knew much about the environmental impact of medicines.

Sadreghaemy sees this lack of awareness as a missed opportunity. He points to diclofenac, a commonly prescribed painkiller in the Netherlands, as an example.

“Diclofenac stays in surface water and can be toxic to animals. Antibiotics and cancer drugs can also cause serious damage. When antibiotics end up in wastewater, bacteria can develop resistance, making those drugs less effective in the future. That’s a real danger for everyone.”

One striking insight from the research: people’s medicine choices don’t always align with their general behavior around sustainability.

“Someone who buys organic food and avoids plastic might still opt for the less sustainable medicine,” says Sadreghaemy. “Meanwhile, someone with little ‘green’ behavior might deliberately choose the eco-friendlier option.”

That means health communication needs to be more targeted. “People respond to different types of messages. There’s no one-size-fits-all approach.”

Sadreghaemy believes that raising awareness is crucial, not only among patients but also among health care providers.

“Advice on medicine sustainability should be tailored to the person in front of you,” he explains. “Someone who’s concerned about costs may be more motivated to reduce waste. That also helps the environment.”

Another notable finding: most patients are willing to return unused medicines to the pharmacy. Yet in practice, many medications still end up being flushed or thrown away. Clear labeling could make a big difference, says Sadreghaemy.

“Why not add a simple message on the packaging: ‘Return this to your pharmacy’? We already do this with batteries. It could really help with medicines too.”

Sadreghaemy sees this research as a starting point for a broader shift toward more sustainable health care.

“If people know how medicines affect the environment, they can act accordingly,” he says. “Health care can become both greener and more cost-effective. That’s possible through smarter medicine use and better production methods. I truly believe we can achieve that.”

The research was carried out by a team from Utrecht University with expertise in pharmaceutical care and sustainability. Using a so-called discrete choice experiment, they analyzed the preferences of thousands of medicine users. In this method, participants repeatedly choose between two product options with varying attributes, revealing which factors weigh most heavily in their decision-making.

This study was conducted among participants in the Dutch Pharmacy Monitoring Panel (AMP), most of whom were over 60. The researchers plan to expand their research to younger participants, such as students and young adults, in future studies.