Abstract
In 2010, NHS accounted for ∼4% of total national emissions, with pharmaceuticals as the major contributor. The US healthcare system accounts for a significant fraction of the national air pollution emissions, paradoxically accounting for 405,000-470,000 DALYs in 2013. Pharmaceutical production and usage in sites with poor wastewater management have resulted in ecological and human health risks due to high concentrations of active pharmaceutical ingredients within 26% of studied rivers. This systematic review aims at clarifying how health economic evaluation (HEE) and health technology assessment (HTA) can be utilized to mitigate the environmental impact (EI) of health care.
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