A number of policy recommendations identify the general public as a key participant in environmentally sustainable pharmaceutical policies. However, research into pharmaceuticals-related environmental issues from the population perspective is scarce. We studied the awareness among Finnish adults (n = 2030) of pharmaceutical residues in Finnish waterways, their perceived environmental sources, views on pharmaceuticals-related environmental issues, and their association with background characteristics. Of the respondents, 89.5% were aware of the presence of pharmaceuticals in Finnish waterways. Wastewaters from the pharmaceutical industry were most frequently, and pharmaceuticals excreted by humans least frequently, considered a major environmental source of pharmaceuticals. The vast majority of the respondents were worried about the environmental and health impact of pharmaceutical residues and emphasized issues such as the importance of environmentally sustainable actions by pharmaceutical companies and the recyclability of the pharmaceutical packaging materials. Age, education, use of prescription medicines, and environmental attitude were associated with awareness of pharmaceutical residues, while gender, age, education level, and environmental attitude were associated most frequently with pharmaceuticals-related environmental considerations. These results indicate a need for improved communication about the environmental effects of pharmaceuticals and the significance of different pharmaceutical emission sources in order to promote a more environmentally friendly, effective pharmaceutical policy.

The use of pharmaceuticals is their main pathway to the environment, making the public a major stakeholder in environmentally friendly pharmaceutical policies, including an environmental classification system for medicines. We studied the Finnish adult population’s (n = 2030) preferences and willingness to pay (WTP) for an environmentally friendly pharmaceutical policy by means of an online survey employing a discrete choice experiment (DCE). We also studied the relative importance of the policy attributes, namely, the environmental impact, geographical scope, available information about the environmental impact of a pharmaceutical, and the effect of the respondents’ general environmental attitudes on the WTP. The total annual WTP of the Finnish adult population ranges from 37 million to 134 million euros, depending on the attribute levels. Moreover, the environmental attitude of a respondent had a significant impact on the WTP. Generally, the environmental impact of the policy was the most important attribute, the geographical scope of the policy the second, and information about the environmental impact of pharmaceuticals was the third most important attribute. However, the most environmentally friendly respondents preferred information as the second important attribute. This study provides insights into the environmental valuations of the public to be used in preparing new pharmaceutical policy measures.

The normal use of medicines is the major environmental source of pharmaceuticals and a significant contributor to the chemicalization of the environment. Despite the key role of medicine users in contributing to this environmental challenge, little research has been conducted into the current state of lay people's pharmaceuticalsrelated environmental information, namely the information received, the information needed, the topics included in the information received, topics of interest, and previous and preferred information channels. In this study, these aspects were studied among 2,030 Finnish adults by means of an electronic survey. Of the respondents, 84.5% had received information related to pharmaceuticals in the environment (PiE). Female gender, higher age, high education level, general environmental friendliness, and use of prescription medicines were associated with a greater likelihood that information had been received. Furthermore, 39.8% of the respondents considered the amount of information received to be sufficient. Respondents had most commonly received information on 1 to 3 different topics. Proper disposal of medicines and pharmaceutical residues ending up in the environment in general were the most common topics covered by the information received. Medicines disposal and the effects of environmental pharmaceutical residues on people were the most interesting topics among the respondents. PiE-related information was most commonly obtained from traditional media (80.4%) and websites (40.5%), the least common source of PiE-related information being physicians (1.6%). The respondents were eager to receive such information in the future, preferring traditional media and medicine package leaflets as the most convenient information channels. These findings indicate a need for more diverse PiE-related information via easily accessible information channels that can vary based on sociodemographic characteristics.

Environmental impacts of medicines are increasingly recognised but rarely embedded in their pricing and reimbursement (P&R) and related assessments. This scoping review mapped how environmental aspects, including antimicrobial resistance (AMR) stewardship, are or could be considered in P&R of medicines and identified challenges for their implementation. Electronic searches from PubMed, Scopus, Web of Science, Edilex, HeinOnline, Westlaw, Google Scholar and official agencies' websites were conducted. Eligible items covered developed country settings and described existing or proposed integration of environmental aspects into medicine pricing or reimbursement. Of 4476 publications, 21 were included. The publications were from 2013 to 2023, most of them addressing ecotoxicological and climate impacts. Six types of means to embed environmental aspects into P&R were identified: health technology assessment (HTA) integration, reimbursement criteria, pricing criteria, environmental classification, regulation and delinkage models. Most proposals were conceptual, whereas implemented or piloted examples focused on AMR‐oriented means. Reported challenges for implementation included challenges regarding data availability, comparability and verification; valuation and methodological integration; incentive design and cost distribution; and equity and political feasibility. Environmental aspects are not yet routine in medicine P&R assessments due to a lack of standardised, verifiable product‐level data, appraisal methods and equity‐sensitive policy design.