Medical device recycling programs are a way to extort money from manufacturers, disguised as sustainability initiatives
7 mins read

Medical device recycling programs are a way to extort money from manufacturers, disguised as sustainability initiatives

The established environmental mantra of “reduce, reuse, recycle” has opened the door for medical device manufacturers to implement recycling programs under the guise of sustainability efforts. In practice, however, these programs benefit no one but the manufacturers themselves. Hospitals would be much better served if they focused on reuse and recycling programs instead, but in many cases their hands are tied.

Let’s take a closer look at why this is happening and why it needs to change.

Unsustainable device recycling costs

When it comes to medical devices, many concepts are used in the name of sustainability, including:

  • Reuse: Reusable devices are designed by the manufacturer to be used a certain number of times.
  • Utilization: Reprocessing is the process by which the FDA authorizes reprocessors to collect, identify, clean, test, and sterilize used single-use medical devices and then resell them to a hospital.
  • Recycling: In recycling, devices are broken down into their component parts and some of the materials (but not all) are recycled.

Recycling medical devices is the “most expensive” sustainability solution for at least three reasons:

  1. Environmental: When a device is recycled, some of the materials (but not all) are recycled. (The industry has suggested that about 23 percent of surgical waste can be recycled. For example, many parts of a typical heart device simply can’t be recycled.) The process is energy-intensive. By comparison, recycled devices are a more environmentally friendly option, with less than half the environmental impact of a new device in terms of carbon dioxide emissions.
  2. Financial: In the case of recycling, the hospital still has to buy a new device. In comparison, hospitals can buy back recycled devices for a fraction of the price of a new device.
  3. Supply chain: When used devices are disassembled into their component parts and recycled, the devices are removed from the supply chain. At a time when hospitals are experiencing delays in fulfilling orders for some of their most critical devices, recycling seriously threatens supply chain resilience.

Traditional healthcare sustainability programs have been simple recycling programs—and very expensive initiatives. On the other hand, today’s emerging circular programs—which focus more on reuse, repair, and remanufacturing—combine environmental sustainability with financial benefit. When an item is not broken down into its component parts, but rather prepared for a second use, there is a balance in the sustainability-cost equation. Truly circular solutions reduce costs and environmental impact.

(image provided by the author)

Physicians as Champions of Environmental Sustainability in Healthcare

So how should hospital supply chains use this information? Single-use devices are bad for the environment and the hospital economy. Reusable devices are the most environmentally responsible option. When only single-use devices are available, recyclable devices should be preferred. Recyclable solutions are the least valuable option from both an environmental and financial perspective.

Interestingly, physicians are increasingly committed to environmentally responsible solutions regarding device use. For example, a recent study found that electrophysiologists are highly motivated to reduce the environmental impact of electrophysiology procedures. A total of 278 physicians from 42 hospitals were surveyed, and 62 percent were motivated to work on more sustainable solutions. Reusing catheters was the most frequently mentioned potential sustainability solution by respondents.

This is great news in laboratories, where more than half of used catheters are discarded as medical waste and less than 20 percent of catheters are reused. There are two ways to increase reuse in the EP lab: manufacturers can design and market reusable catheters instead of single-use catheters, or hospitals can work with reprocessors to reuse single-use catheters.

The Producer’s Role in Perpetuating Unbalanced Programs

So how are manufacturers responding to this desire by physicians to become more sustainable? We’ve seen some of the largest manufacturers launch “sustainability programs” based on medical device recycling. They appear to be responding to the increased demand for environmental sustainability in the hospital. The problem is, these types of programs simply aren’t as good as they seem. In fact, they’re counterproductive and exacerbate some pretty serious supply chain problems. But they do ensure that manufacturers can continue to grow their revenues.

From an environmental perspective, as noted above, recycling is a much less valuable circular solution than reprocessing. Devices from these programs will not be reused, but rather disassembled, and the recyclable parts (less than 30 percent of the remaining hospital waste) will be used to make other products. If the devices were reprocessed instead, the entire catheter would be recovered and made available for another use using very few resources.

Since many single-use devices can be reprocessed and reused, implementing a recycling program simply means that the environmental benefits are reduced. A recycling program means that a new catheter will be needed. In other words: every time a catheter is recycled instead of reprocessed, the hospital significantly increases its CO2 emissions.

So why have some of the largest medical device suppliers implemented a program that increases CO2 emissions and makes supplies scarce? It’s a simple matter of math: Every time a medical device is recycled instead of remanufactured, the manufacturer increases its revenue and the hospital increases its costs. This is because the hospital cannot buy a remanufactured medical device at a lower price, but must buy a new one. Possible supply shortages, damage to the environment and the hospital economy are collateral damage.

That’s the only way medical device recycling programs make sense: when they make sense (and are worth pennies) to the manufacturer. In the meantime, the environment, the hospital, and patients have to pay the price. It’s time to change that narrative.

Photo: ChrisGorgio, Getty Images

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Lars Thording, Ph.D., serves as Vice President of Marketing and Public Affairs for Innovative Health LLC. He has a background in academia, consulting, and industry leadership, and has been responsible for bringing numerous breakthroughs to market in healthcare, insurance, and technology. A native of Denmark, Thording has taught at universities in Denmark, Ireland, and the United States. He currently serves as Vice President of Marketing and Public Affairs for Innovative Health, a medical device reprocessor specializing in electrophysiology and cardiology technology. Lars currently serves on the board of the Association of Medical Device Reprocessors.

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