The benefits of ePI for patients and the planet

With one change made by one pharmaceutical company, we could save half a million trees every year. Imagine the impact if the change was made across industry.

Pharmaceutical companies produce 100 billion paper product information leaflets for medicines yearly, generating 500,000 tonnes of carbon dioxide – the equivalent of almost 100,000 homes’ annual electricity use.¹ In the US alone, producing paper leaflets uses 41.6 billion litres of water each year.² But despite the huge amount of resources invested, these paper leaflets sometimes fail to meet the needs of today’s society, are often not read or understood, and are needlessly printed for repeat prescriptions.

Pharmaceutical companies are now harnessing the power of digital to reduce waste and drive efficiencies across the industry, and this is no different for product information. Electronic product information (ePI) enables access to a digital version of prescribing paper leaflets through web and mobile applications, often by scanning a QR code shown on the medicine pack.

This simple yet effective digital solution has already been successfully implemented in several countries and has the potential to significantly benefit not only the planet, but also patients, doctors, and healthcare systems. Nonetheless, to realise its full impact and drive a transition towards a greener future, collaboration between industry partners, government, and healthcare systems will be vital.

The benefits of ePI for the planet

ePI could be a game changer when it comes to reducing the environmental impact of pharmaceutical supply chains. Not only does it enable paper leaflets to be removed from medicine packs, but it also allows packs to be smaller. This in turn reduces the resources used, and the waste and emissions generated, ultimately enabling access to product information that is both more sustainable and more accessible.

At the AstraZeneca Maihara manufacturing site in Japan, for example, transitioning from paper leaflets to ePI saved 30 million sheets of paper in one year. However, this is just the tip of the iceberg – if ePI were to be rolled out across all AstraZeneca medicines, it has the potential to save 500,000 trees, 50,000 equivalent CO2 (GWP-weighted greenhouse gas emissions), and 1.6bn litres of water per year (640 Olympic-sized swimming pools). These are significant numbers, and the impact would only be multiplied if the change was implemented across industry.

Starting small and gradually expanding has been key to the success of the programme so far, and the achievements we have seen in markets such as Japan validate this learning.

Improving patient care and health literacy

Beyond the sustainability implications, a digital format for prescribing information can also lead to better patient and caregiver understanding. In the UK, a study found that over a quarter of people taking medicine did not read the paper patient information leaflet – for reasons that included the information being too technical or difficult to understand. Similarly, in the US, fewer than 50% of people who take medicines containing product information read it.²

ePI makes product information easy to access, and simple to understand, offering the potential to:

• link to other educational sources
• use audio and video for greater accessibility
• make content searchable, easily readable, and multilingual

The success of ePI has already been shown, with results from a recent patient study finding that 98% of respondents had a positive experience using digital instructions, and almost 80% preferring the digital format.³

There are also potential benefits for patient safety, as ePI enables label updates to be made in real-time, meaning patients can receive the most up-to-date information when they need it.

Less paper also means faster access to medicines

With ePI, companies can roll out new medicines more efficiently. For example, in Singapore, AstraZeneca was able to launch treatments for breast and gastric cancer, gastroesophageal adenocarcinoma, hyperkalaemia, and neurofibromatosis type I up to 3 months earlier than if a paper leaflet was required. For people living with conditions such as these, this time difference could be very important.

Without the restrictions of paper leaflets being printed in one language, medicines could move between countries per demand, helping to address supply chain issues, and mitigating product shortages caused by relabelling and stock allocation. The customisable features that ePI can offer also mean that product information can be shared across different markets much more easily. Countries that may not have had access to certain medicines due to low demand could share packs with other countries, potentially giving patients lifesaving access to treatments that were previously unavailable.

There are many factors to consider when challenging the status quo

Whilst ePI brings with it a whole host of benefits, certain barriers such as limited internet access or varying levels of digital literacy, must be respected. Ensuring that everyone can access the medical information they need remains the ultimate priority, and steps must be taken to ensure this is possible.

To facilitate this, working in direct partnership with patient communities, pharmacists, and other healthcare professionals is necessary, to ensure their individual needs are met as part of the ongoing rollout. Local cultural, technical, and regulatory factors are important to consider, so collaboration between industry, government, and healthcare authorities will be essential to ensure a smooth transition.

Other steps can also be taken to ensure flexibility as part of the transition; for example, in Australia, where paper leaflets are still available from a pharmacist on request.

Future collaboration is key

Overall, ePI represents a significant opportunity to deliver benefits to people, the planet, and society. It has seen success in recent years - for example, with Japan being fully paperless since the end of 2022 - but cross-industry collaboration is now critical to accelerate its widespread adoption. Organisations such as the ePI taskforce in the UK, EFPIA in Europe, RDPAC in China, AMPI in the US, and Interfarma in Brazil will play a key role, facilitating collaboration between governments, industry, regulators, patient organisations, and health technology developers.

AstraZeneca is actively working to encourage a swifter pace of change across industry, through external advocacy efforts in local markets, and ensuring system readiness across sites. Nevertheless, to realise the full potential of ePI, and to catalyse a broader industry shift, engagement from all relevant stakeholders and a system-wide readiness for change will be crucial.