ESPE Abstracts

Background: Growth hormone (GH) therapy typically involves daily administration of recombinant-human growth hormone (r-hGH) injections over many years. Long-term treatment attracts substantial costs due to the regular usage of injector pens. We conducted a study to understand the environmental impact of reusable and disposable GH injector pens.

Aim: To assess environmental sustainability of Aluetta^® reusable pen versus other disposable injector pens used for r-hGH treatment.

Method: Three types of GH injector pens namely, Aluetta^® (Merck Healthcare KGaA, Darmstadt, Germany; quantity=1), Genotropin^® GoQuick^® (Pfizer Inc., NY, USA; quantity=1) and Norditropin^® FlexPro^® (Novo Nordisk A/S, Bagsværd, Denmark; quantity=2) were compared (without product/drug cartridge). A test was performed to assess the total mass of plastic and metal on each injection pen in the Laboratoire National de Métrologie et d’Essais, Trappes at controlled temperature and relative humidity (RH) conditions (23°C±5°C/50% RH ±25% RH) according to test protocol (P228277/DEC1). Balance with a 0.0001 gram resolution was used for mass weighing. Using mass of each pen, an estimate of energy consumed in producing such pens for 3 years of treatment was calculated (assuming use of one Aluetta^® pen for 3 years versus one pen/week for other pens). This energy was converted into equivalent days for home power usage, kilometers driven with electric car and number of Aluetta^® pens that can be produced.

Results: Total mass of plastic and metal parts on Aluetta^® pen is 34.8 grams compared to Genotropin^® GoQuick^® pen (48 grams) and Norditropin® FlexPro^® pen (25.2 grams) in the timeframe assessed. Our analysis indicated that, over 3-year treatment period, total energy consumed in producing Aluetta^® pen was lower (1.18 Kilowatt-hour) compared to Genotropin^® GoQuick^® pens (149.36 Kilowatt-hour) and Norditropin^® FlexPro^® pens (115.45 Kilowatt-hour). Aluetta^® pens produced using this amount of energy can serve another 126 patients as compared to Genotropin^® GoQuick^® and 98 patients as compared to Norditropin^® FlexPro^®. Correspondingly, if we calculate the savings with Aluetta^® versus Genotropin^® GoQuick^® or Norditropin^® FlexPro^® pens, 15.5 or 11.9 house days of power can be utilized, 748 or 577 kilometers can be driven, resulting in 105 or 81 kilograms of CO₂ savings, respectively.

Conclusion: The reusable Aluetta^® injector pen lasts over several years of GH treatment, saving considerable amount of energy that can be beneficially used for various purposes considering environmental sustainability. This tangible study highlights an environmentally-conscientious approach with Aluetta^® pens and the need of adopting greener solutions.