By: Henk Dieteren, Clinical Trial Supply Consultant, Suvoda
Snapshot:
- Environmental impact: Clinical trials produced the equivalent of 27.5 million tons of CO2e, with 70% of drug kits sometimes going to waste.1
- Technology solutions: eClinical software like IRT used in decentralized trials can help address major emission sources.
- Industry momentum: Major pharmaceutical companies commit to emissions targets while new collaborations drive measurement and reduction efforts.
Clinical trials can save lives by bringing new treatments to patients. But they also can generate significant environmental costs. According to Adshead et al,1 the emissions from over 350,000 global clinical trials was the equivalent of 27.5 million tons of CO2e in 2021. That’s roughly comparable to the yearly emissions of 6.4 million passenger cars driven in the US.
Today, the same innovation driving medical breakthroughs can also drive environmental progress as CROs and sponsors seek to reduce their carbon footprint. This blog explores two major contributors to clinical trial carbon emissions and how eClinical technology can help reduce emissions and maintain trial quality and integrity.
Drug waste accounts for substantial trial emissions
According to one analysis, 43% of clinical trial emissions come from drug products themselves.2 Another study found that 70% of packaged and labeled kits never reach patients, indicating the potential scale of drug waste in the industry.3
Waste stems from factors such as inaccurate enrollment predictions and fixed allocation strategies that don't adjust to actual site needs. Sites will receive more kits than needed while others face shortages, potentially causing emergency shipments (which can result in additional costs and emissions) or protocol deviations.
This waste creates not only environmental impacts but can impact trials as well. Over 4,000 oncology trials are already running with at least one already approved and on-market drug in shortage,4 which means that these drugs are no longer available for regular treatments for patients in facing cancer. And when trials are delayed or halted due to shortages, patients can be left waiting longer for the treatments they desperately need. These opportunity costs create an ethical conflict with principles of fairness and access to care. Said in other words, the industry cannot afford to waste available supplies.
Drug transportation and patient travel create additional emissions
Drug transportation represents a significant emission source throughout the trial lifecycle, from initial manufacturing to final site delivery. Global trials involve multiple shipment legs, e.g. from manufacturers to regional depots or depots to sites. Each movement generates emissions through fuel consumption, refrigeration for temperature-controlled products, and shipping materials for safe transport.
Patient travel is another contributing emissions source. Studies show clinical trial visits require five times more patient travel than typical medical appointments.5 This increased travel burden stems from specialized site locations and more frequent protocol-required visits.
A UK study illustrates this challenge. The study found that transportation accounted for 80% of the trial's total carbon emissions, with participants averaging 80-83 kilometers per visit compared to just 2.4 kilometers for primary care appointments.5,6
Technology can address major emission sources
Clinical research today can take advantage of digital solutions that not only increase trial efficiency but also have the capacity to reduce trial-related emissions.
Advanced drug supply management shifts static allocation to dynamic optimization. Modern IRT systems—like Suvoda IRT—use predictive analytics to forecast participant enrollment patterns and adjust inventory levels in real-time. Sites can then receive appropriate supplies based on actual enrollment rather than conservative estimates.
Dynamic drug pooling strategies help trial supply managers to share inventory across regions, moving supplies to where they're needed most. Real-world implementations have demonstrated cost savings of 30-40% of clinical drug budgets while reducing waste at both site and depot levels.7 The ability to set granular supply strategy parameters can lead to a reduction in manufacturing needs and, consequently, a lower impact on greenhouse gas emissions.
eClinical patient engagement technologies like those on the Suvoda Platform can address travel-related emissions by supporting decentralized and hybrid trial approaches.
For example, eConsent can reduce some site visits by allowing participants to review and sign consent forms electronically. eCOA enables patients to complete questionnaires and assessments from home rather than traveling to sites for data collection.
A mobile app can further support decentralized trials serving as one-stop interface for patients where they may schedule appointments, receive reminders, report health outcomes, arrange for travel, and receive reimbursements. Research shows that typical decentralized trials can reduce patient travel by 40-60%.2 Even hybrid decentralization creates meaningful emission reductions while maintaining study integrity.
Industry leaders have committed to sustainable practices
Sustainability and clinical research continue advancing, driven by regulatory requirements and industry recognition that environmental responsibility and operational efficiency often align. Major pharmaceutical companies have committed to ambitious targets. For example, both Novartis and Pfizer aim for net-zero emissions by 2040.8,9
Starting in 2025, members of the Sustainable Markets Initiative (SMI) Health Systems Task Force will seek to measure emissions from Phase 2 and 3 trials, creating unprecedented dataset for further research and innovation.10 This systematic approach to measurement can accelerate accountability across the industry.
Innovation can create impact
Organizations implementing sustainable practices contribute to a broader transformation, helping the industry move toward environmentally responsible innovation. I believe Suvoda's unified eClinical solutions can help support sustainability goals by optimizing drug supply chains, reducing patient travel through decentralized capabilities, and eliminating redundant processes across trial operations. The Suvoda Platform demonstrates that environmental responsibility and operational excellence can work hand in hand to advance clinical research.
By innovating together, we have an opportunity to minimize environmental impacts and conserve resources without compromising the quality of research or outcomes.
Author
Henk Dieteren
Clinical Trial Supply Consultant,
Suvoda
REPORT
Suvoda Sustainability Report
References:
- Adshead F, Al-Shahi Salman R, Aumonier S, et al. A strategy to reduce the carbon footprint of clinical trials. Lancet. 2021;398(10297):281-282. doi:10.1016/S0140-6736(21)01384-2
- Cohen MJ. How much does a clinical research associate impact a company’s carbon footprint? More than you might think! Drug Discovery and Development. May 1, 2024. Accessed May 14, 2025. https://www.drugdiscoverytrends.com/how-much-does-a-clinical-research-associate-impact-a-companys-carbon-footprint-more-than-you-might-think/.
- Jeandrain A. How Digital Twins are driving sustainability in clinical supply planning. Applied Clinical Trials. November 21, 2021. Accessed May 14, 2025. https://www.appliedclinicaltrialsonline.com/view/how-digital-twins-are-driving-sustainability-in-clinical-supply-planning.
- Newton W. Running low on comparators: Navigating drug shortages in oncology clinical trials. Clinical Trials Arena. November 17, 2022. Accessed May 14, 2025. https://www.clinicaltrialsarena.com/features/oncology-comparator-shortages/.
- Nidhi A. Reducing the carbon footprint of clinical trials: Implementing sustainable practices in clinical research. Nature Environment and Pollution Technology. 2023;22(4):2111-2119. doi:10.46488/nept.2023.v22i04.036
- Borno HT, Zhang L, Siegel A, Chang E, Ryan CJ. At what cost to clinical trial enrollment? A retrospective study of patient travel burden in cancer clinical trials. The Oncologist. 2018;23(10):1242-1249. doi:10.1634/theoncologist.2017-0628
- Dieteren H, Barbero R. From waste to efficiency: Optimizing clinical trial supply chains with drug pooling. Presented at: CTS Europe, February 25, 2025.
- Novartis Environmental Sustainability Strategy. Novartis. July 2022. Accessed May 16, 2025. https://www.novartis.com/sites/novartis_com/files/novartis-environmental-sustainability-strategy-objectives.pdf.
- Net zero by 2040: How pfizer is fighting climate change with ambitious science based goals. Pfizer. May 29, 2022. Accessed May 16, 2025. https://www.pfizer.com/news/articles/net_zero_by_2040_how_pfizer_is_fighting_climate_change_with_ambitious_science_based_goals.
- Open letter to clinical trial community published by members of the Sustainable Markets Initiative Health Systems Task Force. Sustainable Markets Initiative. 2025. Accessed May 16, 2025. https://www.sustainable-markets.org/news/open-letter-to-clinical-trial-community-published-by-members-of-the-sustainable-markets-initiative-health-systems-task-force/.