Fewer Admissions = Fewer Emissions: The Environmental Case for Consumerization of Healthcare

I’ve been speaking and writing about the consumerization of health for years: how patients use tech to control their own care, how gatekeeping is dissolving, how tools once limited to clinicians are now in everyone’s hands. It’s a story of empowerment of consumers, and of disruption of existing systems of care.

What I hadn’t considered was sustainability, the environmental cost buried in our healthcare system, and how that is affected by consumerization. But recently I was prepping for a conversation with someone working on sustainability at a pharma firm, and it opened my eyes.

Houston, We’ve Got A (Environmental) Problem

Healthcare is a bigger polluter than most people realize, and — surprise! — emits more carbon globally than the shipping industry (Think Global Health).

• In the U.S., it’s responsible for roughly 8.5% of the greenhouse gas emissions (Commonwealth Fund).

• More than 70% of that footprint comes from indirect sources—things like the supply chain for drugs and devices, and patient and staff travel (AAMC).

• Medical waste is staggering: the U.S. health system generates about 6,000 tons daily, much of it single-use plastics.

• Inhalers alone are a big contributor. In 2022, inhalers used by Medicare Part D and Medicaid beneficiaries generated emissions equal to the annual electricity use in Riverside, California or Buffalo, NY (PMC).

So despite its many benefits, the current system of healthcare also has a gigantic negative environmental impact. But consumerization works against that — even just by reducing the number of times people need to drive to the doctor’s office.

Think about it: healthcare’s carbon footprint in half would save more than:

• turning Florida carbon neutral

• grounding every US airplane

• making every American home zero-carbon

🤯

Fewer Visits, Less Pollution

Think about what happens when telemedicine — enabled by consumerization-provided high-speed internet and ubiquitous computing devices — replaces clinic visits. A 10-minute video call instead of a 2-hour round trip journey isn’t just more convenient; it cuts emissions by orders of magnitude (even accounting for the impact of electricity generation and transmission, and device manufacture).

As an example, at Stanford Health Care, adding telemedicine cut emissions by 36%, saving 17,000 metric tons of CO₂ over two years (PMC).

It’s the same for the increasing use of online tools and apps, combined with the growing range of over-the-counter medications: fewer visits (for more on this, see In the Future, You’ll Need Your Doctor Less).

We’re also increasingly finding the utility of AI-enabled tools for prevention and early detection (think Apple Watch for atrial fibrillation or deterioration in walking steadiness). And this is just getting started, with enormous potential to reduce hospitalizations—the single largest environmental sink in healthcare.

But It’s Not Just Visits

Of course, reducing clinic visits isn’t the only path to environmental benefit, and pharma companies are working on new approaches that may entail the same number of visits but still way fewer emissions.

One example is GSK’s new albuterol inhaler. Traditional metered-dose inhalers use hydrofluoroalkane propellants, which are powerful greenhouse gases. In fact, inhalers account for about 3% of the entire NHS carbon footprint in the U.K. (Nature). GSK is developing a low-carbon version of their Ventolin (albuterol) inhaler that uses a new propellant with a footprint up to 90% lower than current inhalers. If approved, it could cut GSK’s overall carbon emissions by more than 4 million tons annually (GSK, FT). And with AstraZeneca pursuing a similar product, low-carbon inhalers are likely to become the new standard.

Another example is long-acting HIV injectables. Right now 30 million people worldwide take daily HIV pills. Switching to long-acting injectables means less raw material and less energy to manufacture and transport medications. That’s a huge supply-chain environmental win.

To be fair, neither of these examples is really a consumerization story, at least not yet: patients already use inhalers and pills at home, and injectables often still require clinic visits. But both are moving in that direction. Inhalers, once reformulated, are obvious candidates for eventual OTC status. And HIV therapies are now being tested for safe home self-administration (EATG).

Once home self-administration becomes routine and evidence accumulates on safety and adherence, it’s not hard to imagine both therapies moving over-the-counter. That’s the point where sustainability and consumerization go hand in hand: fewer visits, lower emissions, and more control in the hands of patients.

Healthier and Greener

This all began with my own coming to see the environmental angle of consumerization — though only after someone from pharma raised it. And now I can’t un-see it: healthcare has an environmental problem. Happily, consumerization is already pushing more care away from clinics and into the hands of individuals. Telemedicine, AI-powered wearables, and at-home monitoring show how fewer visits mean fewer emissions—and they’re proof that consumerization and sustainability already go hand in hand.

What’s changing now is the scope of that connection. Product innovations like low-carbon inhalers and long-acting HIV therapies start as sustainability wins, but they only become true consumerization stories once patients can use them independently — ideally through safe home self-administration or eventual OTC access. Taken together, these trends point to a future where consumer-driven health doesn’t just make care more convenient and more effective, but also measurably greener.