Reuse of shipping materials in the intravitreal bevacizumab supply chain: feasibility, cost, and environmental impact

Table 1 CO₂e Emissions Related to Shipping of Repackaged Bevacizumab^a

Component	Standard Practice (kgCO₂e/1000 doses)	Re-Use (kgCO₂e/1000 doses)
Raw Material Extraction & Manufacturing of Shipping Materials^b
Foam (PS)	6.67	0.67
Cardboard	2.54	1.27
Cold Pack Plastic (LDPE)	0.26	0.084
TOTAL EXTRACTION/MANUFACTURING EMISSIONS	9.47	2.02
Transport of New Shipping Materials to Outsourcing Facility
Foam (PS)	0.11	0.01
Cardboard	0.15	0.08
Cold Pack Plastic (LDPE)	0.006	0.0006
Shipping (Drug + Shipping Materials) from Outsourcing Facility to Clinic	3.28	3.28
Return Transport of Used Shipping Materials to Outsourcing Facility^c	0	2.68
TOTAL TRANSPORT EMISSIONS	3.54	2.77
Waste
Cardboard Recycling	9.62	4.81
Foam (PS) Landfill^d	0.053	0.0053
Cold Pack Plastic (LDPE) Landfill^d	0.003	0.001
TOTAL WASTE EMISSIONS	9.68	4.82
TOTAL EMISSIONS	22.70	12.88

Abbreviations: CO₂e, carbon dioxide equivalent; PS, polystyrene; LDPE, low-density polyethylene. ^a CO₂e emissions calculated from the US Environmental Protection Agency (EPA) data on greenhouse gas emissions (see References). ^b Assumes extraction/manufacturing from virgin materials. ^c Assumes ground shipping (600 miles) from clinic to outsourcing facility. ^d Emissions solely based on transportation to landfill (20 miles), as PS and LDPE do not contain biodegradable carbon

ISSN: 2056-9920