The Increasing Value of Environmental Sustainability Assessments in Healthcare Policy and Technology Evaluation
Lindsay Nicholson, Nick Pooley, Gregor Skeldon, Sue Langham, Antony Wright & Nina Embleton
Econ Health Policy 24, 443–447 (2026). doi: 10.1007/s40258-026-01034-6
Introduction
Integrating environmental sustainability into healthcare decision-making is now essential for safeguarding population health and the long-term resilience of healthcare systems. Healthcare contributes an estimated 4–10% of national greenhouse gas (GHG) emissions, and this environmental footprint is intricately linked to human health. As climate change exacerbates disease burden and increases demand for healthcare services, a reinforcing cycle of worsening health and environmental impacts occurs. Breaking this cycle requires coordinated action across procurement, service delivery, and health technology assessment (HTA). Importantly, environmental stewardship often aligns with budget efficiency. Measures such as reducing waste and redesigning care pathways can lower emissions while improving value for money. Consequently, integrating environmental metrics within health economics has evolved from a theoretical discussion into a policy imperative and a meaningful differentiator in market access strategies. This editorial explores global momentum for sustainable healthcare and the emerging role of pathway-based environmental sustainability assessments (ESAs). It outlines key methodological challenges that currently limit its integration into healthcare policy and HTA, particularly the primary limiting factor of availability of healthcare-specific environmental data. Despite these challenges, we demonstrate how ESAs can be applied to generate actionable insights using a real-world case study, IMPACT‑CKD, and highlight the crucial next steps for embedding environmental value in healthcare evaluation.