Transitioning to digital product information to ensure a sustainable future

The impact of the healthcare sector on the environment is no big secret, but a small change could potentially save half a million trees each year, and significantly reduce its carbon footprint.

As it stands, the production of medicines involves making 100 billion paper medicine information leaflets annually, generating 500,000 tonnes of CO₂—equivalent to the annual electricity use of nearly 100,000 homes.¹ In the US alone, producing these leaflets requires 41.6 billion litres of water each year, highlighting the significant impact of the existing system on the environment.² Despite the immense number of resources invested, many paper leaflets go unread, are not understood, and are unnecessarily printed for repeat prescriptions.

Change is needed to enable a greener and more efficient future in this industry. Digital innovation is a critical piece of the response to this challenge, and as part of our ongoing commitment to the environment, AstraZeneca has begun the transition to electronic product information (ePI), with the goal of introducing ePI across all products by 2030.

ePI allows patients to access product information through web and mobile applications by simply scanning a QR code on the medicine pack. This approach not only ensures that patients receive the most up-to-date information, given information can be updated in real-time, but also significantly reduces the environmental impact associated with paper leaflets.

Sustainable practises in healthcare benefit everyone

ePI represents a step towards reducing the environmental footprint of pharmaceutical supply chains by eliminating paper leaflets and reducing packaging size.

Several AstraZeneca markets have already demonstrated the benefits a transition to ePI could bring. For instance, at the Maihara packing site in Japan, 30 million sheets of paper were saved in just one year following the introduction of ePI.³

Assessing pharma’s readiness for digital product information management

If these figures are extrapolated across all AstraZeneca medicines, approximately 500,000 trees, 50,000 tonnes of CO₂, and 1.6 billion litres of water could be saved each year.⁴ Similarly, from an EU perspective, removing paper patient information leaflets (PILs) from all medicine could save 1 Terrawatt hour (TWh) of energy annually, equivalent to the energy consumption of 22 hospital facilities. It could also reduce CO₂ emissions by 140kt, which is equivalent to over 100,000 round-trip flights from Paris to New York.⁶

To ensure these environmental benefits are realised, collaboration between industry, government and healthcare authorities will be essential. Industry and government collaborations, as currently exist in places like South America and Europe, will play a key role in facilitating the widespread adoption of ePI and in ensuring a unified approach to its rollout across regions and markets.

With pilot programmes in 24 markets in AstraZeneca, including Japan, Singapore, Australia, Canada, Spain and Portugal, the feasibility and benefits of a transition to ePI are already plain to see—broader adoption across industry is not just a pipe dream. Progress is being made in Europe, where the EU is taking steps to introduce ePI for all medicines and also establish a central system through which ePI can be accessed.² Similarly in Brazil ePI is allowed in medicines and a paperless pilot is being scoped through collaboration between industry and the Government. Some countries have already fully embraced the transition to digital, for example in Australia where all oral and non-parenteral products now utilise electronic product information.²

However, to ensure these programmes can scale, the public and private sectors must commit to finding long-term solutions that satisfy the needs of patients and healthcare providers.

Maximising impact in a transition to ePI

Beyond its environmental benefits, ePI transforms how patients access and understand product information. By linking to educational sources, using audio and video, and making content searchable, multilingual and easier to read, ePI could enhance how patients learn about and understand their medications, which in turn can help improve health literacy.

Features such as adaptable font sizes and compatibility with existing accessibility software can help empower patients with visual or auditory impairments to play an active role in their care management. Real-time label updates are also made possible by ePI, which means patients can always access the most up-to-date information on their medication, potentially enhancing patient safety.

What must not be overlooked is ensuring that all patients have equitable access to the necessary product information. Any ePI transition must ensure access to product information through alternative means for those who need it, so that those with lower digital literacy, or lack of internet access, are also supported. For example, in Australia, pharmacists can print the product information leaflet upon request.

Overall, the perception of ePI and the use of digital solutions in healthcare is positive. A recent patient study showed that 98 percent of respondents had a positive experience with digital instructions and nearly 80 percent preferred the digital format, underscoring the acceptance and preference for digital solutions among patients.⁵ While this positive sentiment is encouraging, it is important to remember that ePI will only be a success if patients actually use it, so ensuring they know how to navigate it is critical.

Collaboration with patient communities, pharmacists and healthcare professionals will be necessary to ensure a transition to ePI fulfils its objectives. Since research shows that most patients get their medication information from their physicians or care providers, these healthcare professionals will play a crucial role in educating patients on ePI and encouraging its use.⁵ Ensuring that appropriate training is provided for healthcare professionals so that they feel supported in their communications on ePI with patients will therefore be essential to its broader success.

If buy-in from both patients and healthcare professionals is achieved, in time ePI can help to facilitate communication with patients, streamline the medication prescription process, and support greater adherence to prescribed medications.

Engaging with patient advocacy groups will also be essential for gaining support and ensuring ePI meets the needs of diverse populations. These groups can advocate for the benefits of ePI, raise awareness and help ensure that the digital solution is accessible and designed with the needs of all target users in mind.

How we set ePI up for future success

Successful implementation requires a unified approach involving all stakeholders to ensure the system is user-friendly, accessible, and meets the needs of diverse populations. By engaging with patient communities, healthcare professionals and advocacy groups, we can ensure that ePI is designed to be inclusive and effective. Continuous engagement with stakeholders and evaluation of its implementation will be crucial to identify areas for improvement and to ensure continued system optimisation. Moreover, fostering a culture of transparency and open communication will help build trust and encourage widespread adoption.

The transition to ePI is not just an environmental imperative but also a step towards creating more efficient and patient-centric healthcare systems. With pilot programmes already demonstrating its feasibility and benefits, broader adoption across the industry is within reach. Together, we can build a robust ePI ecosystem that supports better health outcomes and a healthier planet.

References

1. Road mapping the transition to Digital Medicines Information, Sustainable Medicines Partnership, Roundtable Report. [Internet] Sustainable Medicines Partnership. 2022. [Cited 2024Aug]. Available from: https://static1.squarespace.com/static/60c7833fe1788d03fa8a72d2/t/62ed27976e2cea57c7bbdb11/1659709338982/
2. Electronic product information (ePI): Securing The Future For Accessible Delivery Of Medicine Information Through Digitalisation. [Internet] Health Policy Partnership. 2024. [Cited 2024Aug]. Available from: https://www.healthpolicypartnership.com/app/uploads/Electronic-product-information-ePI-Securing-the-future-for-accessible-delivery-of-medicine-information-through-digitalisation.pdf
3. AstraZeneca. Data on File. ID: REF-237703. [Cited 2024Aug].
4. AstraZeneca. Data on File. ID: REF-222194. [Cited 2024Aug].
5. Patient Feedback Related to Electronic Product Information (ePI). (Survey conducted on 50 participants. 58% are between the ages of 71 and 70 years of age, and 54% are based in North America). [Cited 2024Jun].
6. Unpublished Review Analysis By The European Federation Of Pharmaceutical Industries And Associations (EFPIA) And Deloitte. Benefits Case for Electronic Patient Information (ePI).