Breaking Lock-ins to Enable a Green Pharmacy

Environmentally hazardous pharmaceuticals continue to
be produced,
used, and released to the environment, despite growing recognition
of the need for greener drug design. This study applies a “lock-in”
analytical framework to examine how various interacting social, economic,
political, and technological factors prevent the effective implementation
of concepts such as “benign by design” in drug development.
Using a combination of qualitative and quantitative methods, including
analysis of US and European clinical trial records, we identify two
critical lock-ins: (1) misaligned timing of resources and expertise
among key actors that prevents early integration of environmental
safety and sustainability considerations in drug design, and (2) incentive
structures that promote new drug development over the redesign of
existing pharmaceuticals. Notably, this analysis identifies barriers
to greening both future and existing drugs on the market. Building
on Meadows’ framework for effective interventions in complex
systems, we propose a strategic approach for breaking lock-ins and
present specific recommendations for key stakeholder groups including
policymakers, academia, small biotech, big pharma, and financial institutions.
Addressing these lock-ins is essential to unlocking the full potential
of green innovation in pharmaceutical development, while providing
for patient access to essential medicines.