Scope 3 - Moving from strategy to action to deliver value
This article outlines practical actions leaders are taking to turn the targets from aspirational statements into operational reality and financial outperformance.
Clinical trials, or the study of new tests and treatments for human health outcomes are essential for advancing patient care. However, they remain one of the most complex and least understood sources of pharmaceutical emissions, with one study estimating an average 3260 kg CO2e emitted per patient for all four phases of a clinical trial. Because of their emissions footprint, clinical trials decarbonization has emerged as both a sustainability mandate and opportunity for operational excellence.
As a founding partner of the Industry Low Carbon Clinical Trials group (iLCCT) and the Sustainable Healthcare Coalition (SHC), ERM has helped shape the methods, tools, and partnerships that are redefining sustainable clinical research.
Why clinical trial decarbonization matters now
Decarbonization is now a strategic concern in the pharmaceutical sector. Boards of contract research organizations (CROS), life sciences firms, and R&D organizations are closely involved in climate strategy. This shift has been driven by a growing understanding of the link between climate change and health outcomes, alongside rising stakeholder expectations and the legally mandated net-zero commitments of major health systems.
Industry commitments are reinforcing the trend. The Sustainable Markets Initiative (SMI) Health Systems Task Force, a coalition of global pharmaceutical leaders, is focused on several priorities, including supply chain and patient care pathways decarbonization. Clinical trials sit within this wider agenda, with the coalition now committed to reporting emissions for Phase II and III trials, for trials starting in 2025.
Historically, clinical trials sat within product development pipelines rather than routine operations. Their delivery was often fragmented across labs, contract research organizations (CROs), and couriers, with most emissions falling in the Scope 3 bucket. As a result, most companies relied on spend based estimates, which multiply the total cost of clinical trials by a generic sector-wide macro-economic carbon emission factor. This lack of full visibility meant that significant emissions went unchallenged and unaddressed, despite clinical trials-related Scope 3 emissions being typically five times greater than Scope 1 and Scope 2 emissions combined.
Identifying obscured emissions hotspots within clinical trials
Pharmaceutical companies outsource much of their clinical trial activity, whether it be site operations, laboratory analysis, logistics, sample management, storage, data handling, monitoring, and patient engagement. Because companies do not control these operations directly, they often have limited visibility into the underlying drivers of associated emissions.
Clinical trials’ reliance on spend-based emissions estimation compounds the challenge. When companies estimate emissions based on dollars spent, it can create the false impression that reducing spending lowers emissions, whereas in practice, reductions often stem from operational improvements. Instead, activity-based data can reveal emissions hotspots such as:
- Patient and caregiver travel
- Product manufacturing, packaging, and labelling
- Temperature controlled storage and logistics
- Trial kits
- Sample transport and processing
- Digital platforms and trial technologies
Not insurmountable: Overcoming clinical trial decarbonization challenges
Fragmentation, inconsistent data, a lack of standardized metrics, and cultural barriers hinder clinical trials decarbonization.
Starting with fragmentation, because trial delivery involves multiple vendors, regions, systems, and processes, organizations often lack the activity-level data they need to produce reliable trial footprint estimates. Consequently, assembling a complete baseline can often feel like piecing together a puzzle of mismatched parts.
Operational complexity adds another layer. Trials span diverse geographies, each with their own logistics patterns, patient behaviors, monitoring practices, and regulatory constraints. Without a harmonized method, clinical, sustainability, and procurement teams struggle to access and exchange data, making it difficult to realize meaningful improvements.
Cultural resistance is also common. Trial teams often worry that sustainability interventions might compromise patient safety, trial timelines, or scientific integrity. Still, these concerns usually dissipate once teams see that decarbonization often improves operational efficiency.
The SHC/iLCCT carbon footprint assessment guidance, method, and online calculator helps companies overcome these challenges. Informed by early adopters such as AstraZeneca, Johnson & Johnson, and Novartis, who partnered with ERM, these tools can drive decarbonization opportunities such as:
- Reducing overage by limiting the large volumes of unused trial supplies that occur when patient recruitment falls below expected levels.
- Shifting to virtual or risk-based monitoring, which reduces the need for travel intensive oversight.
- Optimizing sample logistics, which help avoid situations where couriers fly half empty containers.
- Consolidating shipments and reorganizing site operations to minimize unnecessary packaging and transport.
Taking the lead: The role of pharmaceutical companies in clinical trials decarbonization
Stakeholder expectations that sponsor companies will measure and disclose the emissions associated with their trials are rising. For example, a recent Lancet paper urged academia and the clinical research community to embed environmental considerations into trial design and reporting.
Meanwhile, healthcare systems such as the NHS are strengthening emissions transparency requirements in procurement. Although these requirements do not yet explicitly cover clinical development, their broader supplier obligations are shaping expectations across the R&D lifecycle. As they become standard, companies that cannot meet them risk losing credibility, commercial advantage, and product tenders.
By contrast, companies that act early will be able to access:
- Lower trial delivery costs
- Improved patient experience
- Faster recruitment and higher retention
- Reduced operational inefficiencies
- More predictable supply chains
- Stronger relationships with CROs and suppliers
Tools of the trade: What leading companies do differently
Corporate leaders such as AstraZeneca, Johnson & Johnson (J&J), and Novartis have moved to measure their trial footprints and integrate sustainability into their governance processes.
- AstraZeneca and ERM conducted the world’s first clinical trial life cycle assessment (LCA) in 2020. The following year, AstraZeneca quantified all GHG emissions sources in their trials across their therapeutic areas. The results of both analyses formed the basis of a first of its kind roadmap for decarbonizing clinical trials that estimates that AstraZeneca can reduce trial emissions by up to 74% by 2030.
- J&J and ERM conducted LCAs for seven clinical trials, measuring carbon dioxide (CO2e) equivalent emissions. J&J discovered that five activities drove 79% of their clinical trials GHG footprint, information which helped trial sponsors reduce GHG emissions and minimize dependance on these activities in new trials.
- Using the SHC/iLCCT carbon footprint assessment guidance, Novartis implemented several initiatives aimed at GHG emissions reductions, including large scale logistics optimization, reducing site and depot shipments, piloting reusable packaging, and using algorithm-based forecasting to reduce waste. Together, these efforts led to carbon savings of 22,500 tons CO₂e and a total cost avoidance of $45 million between 2020-2024.
Maximizing impact: Linking clinical trials and care pathway decarbonization
Care pathways outline management plans for specific patient populations from start to finish, using evidence-based medicine to ensure standardized best practices. Clinical trials are not separate activities; they often introduce new procedures, diagnostics, dosage forms, and therapy models that influence care delivery. By measuring their carbon footprints sponsors gain early insight into how different treatments may affect the environmental profiles of long-term patient care. The connection also works the other way. ERM’s work on care pathway decarbonization generated detailed emissions data for activities like MRI scans, blood tests, and surgical interventions.
Together, these perspectives build a more coherent understanding of where emissions occur, supporting innovation and helping organizations make more informed decisions about sustainability impacts.
The innovations shaping the next generation of low carbon clinical trials
Digital tools will play a major role in reducing patient burden by minimizing the need for in-person visits, simplifying data collection, and enabling patients to complete key activities from home, ultimately lowering time, travel and logistical burdens.
Promising tools include:
- Remote and risk-based monitoring
- E-Consent platforms
- Wearables and home‑based diagnostics
- Telehealth-enabled trial visits
- Cloud-based data capture systems
However, digital technologies also have an environmental footprint. Supplying patients with new devices, tablets, or sensors can increase emissions unless accompanied by reuse, rental, or bring your own device (BYOD) models. Circular design principles are therefore essential to ensure that technology-driven innovations reduce emissions, rather than increase them.
Moreover, companies can derive some of the biggest carbon emissions and cost savings opportunities from behavioral innovation rather than new technology, whether that is by:
- Aggregating patient trial samples into fewer shipments to cut unnecessary courier trips, reduce packaging use, and improve lab processing efficiency.
- Improving demand forecasting to reduce over-ordering materials, helping avoid waste and emissions linked to unused supplies.
- Reorganizing courier routes and optimizing temperature-controlled logistics so that refrigerated shipments run at higher utilization and in turn lower fuel use and minimize carbon-intensive cold-chain movements.
Where to begin: How to start your clinical trial decarbonization journey?
1. Start now
Effective decarbonization methods and toolkits already exist. By first measuring carbon footprints, companies can identify immediate emissions’ reduction and operational efficiency opportunities.
2. Use available data—perfection not required
Activity-based data is ideal, but even partial visibility on activity-level drivers, operational behaviors, or inventory flows improves decision-making. The shared SHC/iLCCT carbon footprint guidance provides a robust foundation, with many companies already optimizing their trial operations from an emissions perspective.
3. Link sustainability and operational value
By measuring emissions from activity-based data, organizations can unlock a new layer of business value and surface opportunities that align operational cost savings with carbon savings.
Clinical trials are a significant and often overlooked contributor to healthcare's carbon footprint. Decarbonizing clinical research requires the same cross-sector ambition that is reshaping the broader health economy. ERM's role as a technical partner in the Industry Low Carbon Clinical Trials (iLCCT) consortium signals that the expertise and leadership needed to drive this change are now firmly engaged, and that the industry is ready to move from commitment to action.