Thani Jambulingam, PhD

The emergence of glucagon-like peptide-1 (GLP-1) drugs such as liraglutide (Saxenda), semaglutide (Ozempic, Wegovy), and tirzepatide (Mounjaro, Zepbound) has transformed the management of type 2 diabetes and obesity. These drugs are primarily administered via pre-filled injectable pens, offering patients convenience. However, the growing use of these pens introduces significant challenges concerning their disposal. Classified as medical waste, these pens raise environmental, health, and regulatory concerns.

Addressing these issues is essential to ensuring that the advantages of GLP-1 medications are not overshadowed by the unintended consequences of improper waste disposal. This article examines the challenges associated with the disposal of these drug pens and presents potential solutions to mitigate the associated risks.

Challenges in disposing of GLP-1 drug pens

One of the primary issues with GLP-1 drug pens is the presence of built-in needles, which are classified as "sharps." Sharps are considered hazardous waste because they pose a risk of injury or infection. Improper disposal of used pens can result in accidental needle sticks, exposing waste handlers, healthcare workers, and even the public to potential biohazards, including bloodborne pathogens. This risk is exacerbated when these pens are discarded in regular household trash instead of in designated sharps disposal containers. Given the increasing use of GLP-1 drugs for chronic conditions like diabetes and obesity, the volume of sharps waste generated is substantial, raising the potential for injuries if proper disposal protocols are not followed.

GLP-1 pens are single-use devices made from a combination of plastic, metal, and residual medication. These materials can negatively impact the environment if not disposed of properly. Non-biodegradable plastics contribute to the growing problem of plastic waste in landfills, while residual medication can seep into soil and water sources, contaminating ecosystems and harming wildlife. As the number of patients using GLP-1 drugs grows, millions of these pens are discarded each year, amplifying their environmental impact.

Moreover, the disposal of GLP-1 pens is subject to various regulations, which differ across regions. In many areas, these pens are classified as medical waste, requiring disposal in compliance with specific guidelines. Unfortunately, not all patients are aware of these regulations or have access to appropriate disposal facilities. Consequently, many pens are discarded in regular household waste or recycling bins, which is not only unsafe but also illegal in some regions. The lack of consistent regulations across countries and states makes it difficult for pharmaceutical companies to establish uniform disposal protocols.

For patients, the proper disposal of GLP-1 pens can be both inconvenient and costly. Sharps disposal containers, essential for safe disposal, are often not provided for free. Patients may need to purchase these containers or pay for specialized disposal services. In areas where needle drop-off sites or take-back programs are unavailable, patients may have to travel considerable distances to safely dispose of their pens. This inconvenience often leads to noncompliance with disposal guidelines, prompting some patients to discard pens in regular trash due to a lack of accessible alternatives.

One of the most effective ways to address the issue of sharps waste is by expanding the availability of sharps disposal programs. Pharmacies and healthcare providers can distribute sharps containers to patients using GLP-1 pens and educate them about the importance of proper disposal. Local governments and healthcare institutions can also increase the number of needle drop-off sites and mobile collection units, making it more convenient for patients to safely dispose of their pens. Collaborating with pharmaceutical companies to offer free or subsidized sharps containers could also boost compliance rates.

A more sustainable solution involves the implementation of pen take-back programs. Similar to existing programs for expired medications, these initiatives would allow patients to return their used pens to pharmacies or designated collection centers for safe disposal. While some pharmaceutical companies already offer such programs, expanding them globally would provide patients with a convenient, cost-free way to dispose of their pens. Governments could further encourage the establishment of take-back programs by offering tax incentives or subsidies to pharmacies and healthcare providers who participate.

In the long term, transitioning toward reusable injection pens offers a promising solution. In this model, the pen would be reusable, with only the medication cartridge needing replacement. This shift would significantly reduce the amount of plastic and sharps waste generated by each patient. While reusable injection pens already exist for other medications, pharmaceutical companies could develop GLP-1 formulations compatible with this technology. Though the initial cost of reusable pens may be higher, the long-term savings in waste management and environmental impact would be substantial.

The pharmaceutical industry should also explore the possibility of using biodegradable or recyclable materials in the production of GLP-1 pens. Currently, the combination of plastic and metal components makes recycling difficult. However, advancements in biodegradable plastics and eco-friendly materials could provide a solution. Some companies are already researching plant-based or compostable plastics for medical devices, and applying this technology to GLP-1 pens could significantly reduce their environmental footprint.

Educating patients about the importance of proper disposal practices is also crucial to mitigating the risks associated with GLP-1 pens. Healthcare providers, pharmacies, and pharmaceutical companies should include clear instructions on safe disposal with every prescription. Public awareness campaigns, both online and in healthcare settings, can emphasize the risks of improper disposal and inform patients about available resources, such as sharps containers and take-back programs.

The disposal of GLP-1 drug pens presents significant challenges due to the risks posed by sharps, environmental pollution, regulatory inconsistencies, and patient inconvenience. However, these challenges can be addressed by implementing comprehensive sharps disposal programs, promoting take-back initiatives, encouraging the use of reusable pens, developing eco-friendly materials, and raising public awareness. Pharmaceutical companies, healthcare providers, and governments must collaborate to ensure that the growing use of GLP-1 drugs does not result in unintended environmental and public health consequences. By adopting these measures, the medical community can continue to reap the benefits of GLP-1 medications while ensuring responsible waste management.

Thani Jambulingam, PhD, is a professor of food, pharma & healthcare business at Saint Joseph’s University’s Erivan K. Haub School of Business.

Articles

With great power comes great responsibility. In this case, tackling these obstacles is vital to making sure that the positives of GLP-1s are not outweighed by the downfalls of improper waste disposal.