Abstract
BACKGROUND: Pharmaceuticals affect planetary health through environmental contamination from human excretions, improper drug disposal, and greenhouse gas emissions, derived from manufacturing as well as from use. Research suggests that patients will choose environmentally friendly options for minor ailments, but not severe conditions. To date, no Canadian research has explored patients' views on this topic. OBJECTIVES: To characterize the views of British Columbians regarding medication-related environmental sustainability and to determine how these views relate to medication decisions. METHODS: A web-based survey was distributed across British Columbia from October 30, 2023, to February 29, 2024. Residents of British Columbia at least 18 years of age who could complete an online survey in English were eligible to participate. Descriptive statistics and thematic analysis were used. RESULTS: A total of 255 responses were received. When presented with a scenario related to stroke, more than half of respondents (51%) preferred the medication with higher efficacy and greater environmental harm; in contrast, for scenarios involving the common cold and asthma, more than half chose the medication with lower efficacy and lower environmental harm (54% and 59%, respectively). When cost was introduced, only 54% stated they would choose the more environmentally friendly medication if it was more expensive, whereas 97% would do so if it was less expensive. Themes from open-ended questions focused on cost, manufacturer considerations, and education. CONCLUSIONS: Respondents were willing to choose the environmentally friendly medication for less serious conditions, but not for conditions perceived as life-threatening and/or debilitating. Cost may be a barrier to accessing environmentally friendly options. Public education opportunities may help to inform more sustainable choices. Additionally, there may be value in manufacturer regulations or policies to ensure that the environmental impact of medications is considered.