start₂ – An Environmental Classification for Pharmaceuticals for Human Use in Germany

The parent project start developed a broad spectrum of precautionary options of action for reducing the contamination of water bodies with active pharmaceutical ingredients. A key element is the implementation of an environmental classification of pharmaceuticals for human use in Germany. As an easy-to-use decision support tool it allows physicians to prescribe the environmentally more benign substance in cases where therapeutically equivalent alternatives are available. By increasingly prescribing active ingredients which are e.g. more rapidly biodegradable the actors of the health care system can thus directly contribute to the prevention of contamination of water bodies.

Such an environmental classification for pharmaceuticals for human use is available in Sweden since 2004. Swedish physicians increasingly accept the classification as part of their daily medical routine. It is unclear to date to what extent these positive experiences can be transferred to Germany with its much larger market for pharmaceutical products and its different institutional and political frameworks. The project thus aims at critically exploring the potential of the implementation of an environmental classification. This is achieved via a stakeholder dialogue with representatives from the health care system, the pharmaceutical industry, the Administration, consumer and patient organisations as well as the water management.

By means of this approach the successful start initiatives for strengthening the coping capacity of societies in dealing with pharmaceutical residues in drinking water are carried forward. An overarching objective here is to gain transferable insights into the conditions of success for participative processes of a systemic risk management.

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