Consortium Spotlight: Meet Melissa Pegg Senior Research Consultant from York Health Economics Consortium
Welcome to our Consortium Spotlight, where we shine a light on our diverse community of experts dedicated to reducing the environmental impact of medicines in UK healthcare. This month we feature Melissa Pegg, a Senior Research Consultant in Environmental Sustainability in Health Technology Assessment.
Q&A with Melissa Pegg:
How do your professional and/or personal interests link to the work done by the Pharma Pollution Hub?
“I am passionate about developing sustainability in healthcare, and this informs my work as lead of the Environmental Sustainability team at York Health Economics Consortium (YHEC), a consultancy organisation owned by the University of York. The YHEC Environmental Sustainability team focuses on incorporating environmental impact methods into health technology assessment (HTA) and health economics reporting for clients including the NHS, government bodies, and the healthcare industry. We have extensive experience working with different stakeholder groups at each decision-making point and understand the complexities of environmental life cycle assessment. The work being done by the Pharma Pollution Hub is exceptionally valuable to YHEC because it supports a system-wide, transdisciplinary, and multiple-pronged approach that will drive solutions to reduce the environmental impact of medicines. We are delighted to be part of the Pharma Pollution Hub healthcare decision-making working group. Together, we hope this collaboration will support collective action and organisational change in a particularly challenging area of healthcare decision-making.”
How do you think your profession can help drive change in reducing the negative environmental impacts of pharmaceutical pollution?
“Globally, there is a need to develop standardised metrics that measure environmental outcomes, impacts, risk assessment, mitigation, and adaptation techniques, and to prioritise environmental criteria during healthcare decision-making. For example, a three-pronged decision-making tool could be implemented that considers health and health service outcomes, climate and environmental outcomes, and socio-economic outcomes. At YHEC, we combine expertise in measuring environmental impact with economic modelling, and we use existing frameworks to standardise methodologies that support data sharing. Consideration of pharmaceutical pollution could be integrated into healthcare decision-making at multiple touchpoints within the healthcare system, each involving different stakeholder groups. Our work across multiple sectors and with key stakeholders allows us to promote the importance of environmental sustainability throughout the healthcare decision-making process. This will help to mobilise the transition to more sustainable healthcare and reduce the negative impact of pharmaceutical pollution.”
If you had a magic wand, which part of the UK healthcare pharmaceutical system would you change and why?
“Pharmaceutical supply chains are typically long, complex, and global. However, it is widely accepted that there is a need to introduce regulation to promote environmental life cycle assessment for pharmaceuticals. Currently, there is a paucity of data reporting the environmental impact of generic medicines. Increasing access to this environmental data will enable more sustainable decision-making. Alongside this, further regulation in environmental monitoring and appropriate screening methods is necessary. This could be used, for example, to assess the environmental impact of pharmaceuticals on drinking water. Extensive research is also needed to understand the co-benefits (monetary, environmental, social) of non-pharmaceutical interventions compared with pharmaceuticals, which will support minimising the use of pharmaceuticals where appropriate. These measures – particularly if implemented concurrently – would drive (much needed) environmental data generation. This evidence would help support regulatory changes to integrate healthcare sustainability in decision-making.”
Is there anything else you would like to share with our community about your work linked to our mission?
“At YHEC, we are leading efforts to integrate sustainability into healthcare life cycle assessments, pioneering research methods, and educating a wide range of stakeholders on how to do the same. Just last week, I received the University of Glasgow Prize for Best HTA MSc Project 2022-23 for the work I undertook evaluating methods to incorporate environmental sustainability in HTA. The output from this work supports the HTA community in developing appropriate tools to assess pharmaceutical pollution in terms of health, economic and environmental outcomes. In 2023, I undertook the first environmental assessment comparing single use versus reusable rhinolaryngoscopes for the Scottish Heath Technologies Group (SHTG) (Health Improvement Scotland), alongside health economic analysis. The SHTG Parallel Assessment Report will be published soon. More recently, I worked closely with industry to validate an environmental model being submitted to the NHS, alongside health economic data. This type of environmental analysis has been recently termed an Information Conduit Report; one of the approaches the National Institute of Health and Care Excellence are starting to consider. Currently, I am working closely with my health economics colleagues on a carbon and cost comparison model for a client that supports reporting financial data alongside environmental data; crucial for NHS decision-making processes going forward. In addition, alongside the important work starting to be undertaken between industry and HTA in terms of environmental reporting, education is critical to foster environmental reporting best practice. In March, I will be delivering a training course along with Mat Taylor, Director at YHEC on ‘Environmental Sustainability in Health Technology Assessment’. This will include how to get the best out of environmental data, promoting a cultural change to life cycle assessment reporting from a HTA perspective. Furthermore, I am very much looking forward to Health Technology Assessment International (HTAi) Annual Meeting 2024 in Seville, Spain (15-19 June). Where discussions will surround the main theme for HTAi 2024, ‘A Turning Point for HTA? Sustainability, Networks and Innovation’, and where I am part of an international panel and have the fantastic opportunity to also present on developing and utilising multidisciplinary methods to evaluate environmental sustainability in HTA. Please contact me for further information about the wide range of work packages I offer at YHEC.”
Melissa Pegg is dedicated to integrating sustainability into our healthcare decision-making, which makes her a valuable member of the Pharma Pollution Hub. Stay tuned for more insights from our consortium coming soon.