Are people’s behaviours preventing drug delivery devices from achieving their sustainability aims?

Where sustainability meets reality

Imagine a patient administering an injection at home. The treatment has been successful. The device has worked exactly as intended. The patient has completed their task and can get on with the rest of their day.

For decades, that is broadly where manufacturers have focused their efforts. The goal has been to ensure that devices are safe, effective and easy to use, and success of any metric beyond that point of delivery hasn’t been much of a consideration.

Now introduce sustainability initiatives. Following delivery, there may be components to separate, packaging to sort or devices to return. Patients might be asked to store used devices until they have enough to fill a postal return envelope. Healthcare professionals may need to follow a new disposal procedure. Procurement teams may begin weighing environmental criteria alongside cost and performance when selecting products. Each one of these factors introduces new understanding and a human decision, and with it, a point of friction in the process.

This challenge becomes particularly relevant as the healthcare industry begins exploring more circular models. Across the industry, organisations are investigating ways to keep products and materials in circulation for longer, reducing waste while maintaining safety and regulatory compliance. It’s a commendable and ultimately necessary ambition that brings with it a significant level of complication.

Recovering, tracing, sorting and reprocessing healthcare technologies requires infrastructure, clear responsibilities and operational systems that work within already overstretched healthcare environments. The environmental benefits may be compelling but achieving them depends on people being part of this system change, requiring them to engage with new, unfamiliar and potentially inconvenient processes.

The behavioural assumptions hidden inside sustainable design

What I find particularly interesting is how easy this challenge is to overlook. When sustainability becomes a design objective, teams can evaluate and compare environmental impacts through lifecycle analysis (LCA). The behavioural assumptions embedded within these decisions aren’t overtly visible.

Designers generate assumptions within the LCAs, for example that users of a reusable platform will retain and maintain the reusable element effectively for its intended life, or that patients will be aware that there is a device return scheme available to them.

It must be said that these assumptions are not unreasonable – they simply deserve a level of scrutiny. Through my work in human factors, I routinely see teams examine whether users can operate a device safely and effectively. Similar thinking and assessment are increasingly necessary when assessing required behaviours to deliver on sustainability strategies.

Device manufacturers need to evaluate if a proposed solution introduces new behaviours and how likely people are to adopt them. They need to ask themselves what communication is needed to engage and motivate users, how much user effort will be required or what barriers might emerge over time. They also need to consider how the solution fits into existing routines and healthcare systems. These factors all have a substantial influence on whether the environmental benefits of new sustainable designs or return schemes will ever be effective in practice.

The disconnect between perception and impact

Outside of user awareness, which shouldn’t be underestimated, motivation is arguably the first hurdle.

During my time in human factors for medical device development, I’ve witnessed patients and healthcare professionals consistently focus on visible waste. They think about the plastic waste left behind after an injection, the amount of packaging arriving with treatments or their unused items in a kit that they repeatedly discard.

In a recent study exploring the sustainability of medical devices with end users, preventing unnecessary item disposal was at the core of their opinions. Reusability and recyclability featured heavily because they appeared to reduce something tangible and immediately visible, but there was not a clear understanding beyond ‘as long as I am not putting it in the bin’ or ‘this one is bulkier, so it is more wasteful’. By contrast, more extended lifecycle considerations receive less attention due to lack of awareness and comprehension. Points like manufacturing emissions, sustainable material selection, or component separation at end of life play a significant role in environmental assessments yet are largely invisible to the end users of a medical device. This creates an interesting disconnect. A sustainability feature that delivers substantial environmental benefit may not necessarily be recognised as such by users. Equally, features that visibly reduce waste can attract strong support even when the broader environmental picture is more complex.

Understanding these perceptions is important because they strongly influence behaviour. People are more likely to engage with sustainability initiatives when they can easily understand the value being created. The challenge for manufacturers is then centred on where they focus their efforts, and importantly, what they communicate to end users and how.

Helping people see environmental impact

Effective communication of environmental impact that resonates with the end user therefore becomes crucial to influence engagement and drive action.

During a study by Team Consulting into user perceptions of medical device sustainability, participants responded more strongly to tangible descriptions of environmental impact than abstract technical metrics. Drawing on emotionally relatable equivalences, such as comparing the impact to the number of disposable bottles saved, helped people visualise environmental outcomes in ways they felt more connection with. Discussions framed around these more recognisable objects also generated stronger engagement than standalone carbon figures.

So, if users are expected to participate in sustainability initiatives, there may be value in communicating environmental benefits in ways that feel more concrete and relatable. Helping people connect actions with outcomes could support both understanding and long-term engagement.

The gap between intention and action

This is all well and good, but there is also a tension that will sound familiar to anyone working in healthcare. In general, patients and healthcare professionals care about sustainability, but what happens when this conversation shifts from aspirations to actions? I’ve heard people describe practical barriers relating to time, effort, convenience, infection control and even awareness. While many say they are willing to participate in return schemes, there is less certainty about real engagement, action and how those behaviours can be sustained over weeks, months or years.

Healthcare already asks a great deal from patients. Treatments must fit around work, family commitments and everyday life. When sustainable actions create additional effort, even relatively small amounts of friction can influence participation. This is particularly relevant for combination product developers. The effectiveness of a system depends a lot on its ease of use.

Making sustainable behaviour easier

As sustainability moves higher up the agenda, there is an opportunity to approach the challenge from a slightly different perspective. Rather than asking only how sustainable a device is, developers now must ask how easy it is for people to behave sustainably when using it. The distinction may seem subtle, but it shifts attention towards participation rather than intention.

Effort matters. Sustainable actions that integrate as seamlessly as possible into existing routines are generally easier to maintain than those requiring significant additional steps. Behavioural science has consistently shown that convenience and supportive interventions influence behaviour, particularly when people are balancing multiple priorities. None of these observations are especially surprising. Yet they often receive less attention than discussions about new materials, product architectures, or packaging approaches.

As sustainable healthcare solutions become more sophisticated, behavioural design and human factors expertise will have an increasingly important role to play alongside engineering innovation.

Looking beyond the device

The pharmaceutical industry is making genuine progress towards more sustainable drug delivery systems. Yet it’s clear sustainability does not end with product design.

Many of the solutions now being explored rely on participation from patients, healthcare professionals, healthcare systems and waste management partners. Their success depends not only on what has been engineered into a product and how the operational system supports the implementation of end-of-life management, but also on whether the end users in the chain engage with and comprehend the sustainable behaviours required of them.

For an industry that has spent decades refining safety, usability and treatment experience, this should feel like familiar territory.

Human factors and behavioural science have long helped developers understand how end users interact with medical devices in the real world. As sustainability becomes a more prominent design objective, the same mindset can help uncover the barriers, motivations and behaviours that shape and achieve environmental outcomes.

The next generation of sustainable drug delivery systems will certainly be influenced by advances in engineering. Their long-term impact, however, may depend just as much on understanding the people who use them.