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A Landscape Analysis of Medicine Carbon Footprints Identifies Antibiotics as a Promising Target for Emission Reduction Interventions

19 Pages Posted: 20 Nov 2023



Background: Healthcare accounts for 5% of global greenhouse gas emissions, with medicines making a sizable contribution. Product-level medicine emission data is limited, hindering mitigation efforts. To address this we created MCF Classifier, a suite of applications to estimate, classify, benchmark, and visualise small molecule medicine carbon footprints.  

Methods: We developed MCF Method, an automated pipeline using molecular weight and chemical structure to estimate the process mass intensity and global warming potential of the active pharmaceutical ingredient in small molecule medicines. This allowed us to estimate medicine carbon footprints per dose, which we categorised into MCF Ratings, accessible via a searchable web application, MCF Formulary. We performed data comparisons and sensitivity analyses to validate the ratings, and stratification analyses by therapeutic indication to identify priority areas for emission reduction interventions.  

Findings: We generated standardised medicine carbon footprints for 2214 products, with 38% rated LOW, 35% MEDIUM, 25% HIGH and 2% VERY HIGH. These products represented 2.2 billion NHS England prescribed doses in Jan 2023, with a total footprint of 140,000 tonnes CO2e, equivalent to the monthly emissions of 940,000 cars. Notably, three antibiotics, amoxicillin, flucloxacillin, and penicillin V, contributed 15% of emissions. Implementing the recommended 20% antibiotic prescription reduction could save 4,200 tonnes CO2e per month, equivalent to removing 29,000 cars.

Interpretation: Standardised medicine carbon footprints have utility in assessing and addressing the carbon emissions of medicines, and the potential to inform and catalyse changes needed to align better healthcare and net zero commitments.

Funding: SBRI Healthcare Programme, an Accelerated Access Collaborative initiative, championed by the Academic Health Science Networks.

Declaration of Interest: The authors declare the following financial interests/personal relationships which may be considered as potential competing interests:
Nazneen Rahman is a Non-Executive Director at AstraZeneca
Matthew Sawyer provides paid educational consultancy on healthcare environmental sustainability

Keywords: medicines, pharmaceuticals, medicine carbon footprint, product carbon footprint, sustainable healthcare, net zero healthcare, antibiotics, antimicrobial resistance

Suggested Citation

Taylor, Haroon and Mahamdallie, Shazia and Sawyer, Matthew and Rahman, Nazneen, A Landscape Analysis of Medicine Carbon Footprints Identifies Antibiotics as a Promising Target for Emission Reduction Interventions. Available at SSRN: or

Haroon Taylor

YewMaker ( email )

Shazia Mahamdallie

YewMaker ( email )

Matthew Sawyer

SEE Sustainability ( email )

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