Prescribing Sustainability

Within The Netherlands, the healthcare industry is responsible for 7.3 percent of the national climate change footprint. Within a hospital, the procurement of medicines is a significant contributor to a hospital’s carbon footprint. This illustrates there is much to win in the reduction of the carbon footprint associated with the procurement of medicine. This thesis explores how economic, environmental, and social sustainability can be integrated into the procurement of medicine for the purchasing group of Dutch academic hospitals (UMCPG) to ultimately decrease this footprint. Recently, the UMCPG introduced a Pilot Supplier Questionnaire (PSQ) including sustainability criteria as a tool to achieve a more sustainable supplier selection process. Semistructured interviews with both purchasers and suppliers revealed key challenges in the PSQ and corresponding tendering process. Findings on the PSQ reveal a lack of understanding about the goal and context of the PQ and its questions, the need for transparency about the outcome of the tender, the need for objectivity in the evaluation of the PSQ, and the desire for a uniform supplier questionnaire across purchasing parties. Findings on the tendering process reveal the complexities of the PSC that impact both parties like drastic medicine shortages, price competition, keeping general healthcare costs low, ensuring high patient safety, and the price tag of sustainability. The theoretical foundation of this thesis builds upon the Theory of Planned Behaviour for green procurement behaviour. Findings reveal that purchasers’ have a positive attitude towards sustainability and green procurement, work-related stakeholders convey the norm for keeping medicine procurement costs low, the sense of behavioural control is biggest as being part of the UMCPG rather than on individual level, and the intention to engage in green procurement is generally positive like the purchasers’ attitude. Based on the findings, the following solutions are designed for the UMCPG: 1) a renewed supplier questionnaire (TSQ) including categories, 2) a decision hierarchy, 3) ‘rebranding’ the procurement process, 4) a recommendation for tender transparency, and 5) suggestions for improving the TSQ including example question types and directions for moving towards a uniform TSQ across purchasing parties. Social sustainability criteria were eventually excluded in the TSQ design, since too little information was gathered on social sustainability during the interviews