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Europe’s once-in-a-decade chance to deliver green healthcare impact

08/07/2026    72

Europe now has a shared standard for measuring pharmaceutical emissions and evidence that healthier patients mean lower healthcare carbon – making 2026 procurement reform the moment to act
Across Europe, governments are buying ‘greener’ medicines. Norway scores them one way, Sweden another, France a third. The same medicine, assessed in different countries, receives different environmental ratings. Right now, ‘green healthcare’ means whatever each country decides it means.

That could change. Europe is rewriting its public procurement rules in 2026, a once-in-a-decade opportunity to embed a common standard into binding policy, and for the first time, that standard exists.

The stakes are high. Europe’s healthcare sector is both driving climate change and suffering from it. It generates significant emissions through pharmaceutical manufacturing, hospital energy use, medical logistics, and the propellants in widely used inhalers.

Those emissions feed back into demand for care: air pollution worsens respiratory disease, rising temperatures drive heat-related illness, and shifting ecosystems spread infection.

Momentum to reduce that footprint is building. According to Procuring for Greener Pharma, a 2022 report by Health Care Without Harm (HCWH) Europe, many companies have shifted over the past five years from asking “why should we do this?” to “how should we do this?”

But momentum without a common framework produces fragmentation, not progress, and that is exactly where Europe finds itself today.

As José Luis Castro, WHO Special Envoy for Chronic Respiratory Diseases, put it at a recent Euractiv Health Policy Conference: “The question of how we address this burden is finding solutions that allow us to have a healthcare system that addresses the needs of the patients, but does not contribute to contaminating the environment.”

A common standard for measurement

Governments are the biggest buyers of medicines in Europe. Public procurement accounts for around 14% of EU GDP; healthcare spending represents 8% of national GDP across the EU.

If procurement rules require companies to demonstrate a medicine’s environmental impact, that creates a powerful incentive to reduce it. But there is no agreed way to measure that impact. Without a common methodology, the incentive has no shared currency.

Each country uses different methods, meaning the same medicine can receive a different environmental score depending on where it is assessed. For a manufacturer responding to tenders across Europe, this creates duplicated compliance burdens with no guarantee of comparability.

As Procuring for Greener Pharma concluded, sustainability criteria need to be “harmonised as much as possible between different European countries to avoid the risk of conflicting or piecemeal standards at the EU level.”

In November 2025, PAS 2090, published by the British Standards Institution with NHS England, the UK Office for Life Sciences, and a consortium of industry stakeholders, gave the sector a shared framework for measuring a medicine’s full environmental impact, from manufacturing through to patient use and disposal.

EFPIA has called on the EU to formally endorse it as the standard across member states.

The 2026 reform is the lever to make that binding across all member states.

Getting the design right: access and resilience

How criteria are designed matters as much as whether they exist. In its 2025 position paper, EFPIA stated that “the environmental and clinical impacts of pharmaceutical products are deeply intertwined with how, when, and where they are used across the continuum of care and cannot be compared as a sole product.”

MedTech Europe’s 2024 position paper reaches the same conclusion: product footprint alone “will not be enough to create overall sustainable healthcare systems.”

The clinical pathway: prevention and disease management

“Every effort must be made to ensure that we prevent the new cases and new people from getting sick,” Castro said at the same conference.

Hospital care is more resource-intensive than community care, more energy, equipment, and drugs across a full episode. That intensity has a carbon cost. EASAC is direct about the implication: reducing healthcare’s footprint requires strategies to reduce disease incidence and severity, “thereby decreasing the amount and intensity of care received.”

For respiratory diseases, the evidence is specific. A 2026 review by Agusti and colleagues, published in npj Primary Care Respiratory Medicine, found that “poorly controlled respiratory diseases have a higher carbon footprint than well-controlled diseases, especially if an individual is hospitalised.

Effective therapy that reduces the occurrence of symptoms and prevents exacerbations will therefore minimise the impact of a respiratory disease on the environment.” The authors’ conclusion is direct: “the main contribution to minimising the impact of chronic respiratory diseases on the climate is to optimise disease control and self-management.”

The quantitative case is equally clear. A 2024 study by Orlovic and colleagues, published in ERJ Open Research and funded by Chiesi, found that a patient with non-severe uncontrolled asthma incurred 22% higher NHS costs than a patient with controlled asthma, while generating 0.1 tonnes more of CO2 equivalent emissions.

“The prevention and primary care are low carbon and high value,” Castro added. “The most sustainable system is the one that prevents the diseases.”

The tools for both pathways now exist: a common measurement standard ready to be embedded in binding policy, and a growing body of evidence that better disease management cuts both healthcare costs and carbon.

The 2026 procurement reform is the moment to get the first right. The second demands the same urgency. Europe can’t waste this opportunity.

Source: Euractiv

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