{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T11:17:05Z","timestamp":1780917425818,"version":"3.54.1"},"reference-count":33,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,5,10]],"date-time":"2026-05-10T00:00:00Z","timestamp":1778371200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,5,10]],"date-time":"2026-05-10T00:00:00Z","timestamp":1778371200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100002327","name":"Kela","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002327","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Basic Clin Pharma Tox"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Environmental impacts of medicines are increasingly recognised but rarely embedded in their pricing and reimbursement (P&amp;R) and related assessments. This scoping review mapped how environmental aspects, including antimicrobial resistance (AMR) stewardship, are or could be considered in P&amp;R of medicines and identified challenges for their implementation. Electronic searches from PubMed, Scopus, Web of Science, Edilex, HeinOnline, Westlaw, Google Scholar and official agencies' websites were conducted. Eligible items covered developed country settings and described existing or proposed integration of environmental aspects into medicine pricing or reimbursement. Of 4476 publications, 21 were included. The publications were from 2013 to 2023, most of them addressing ecotoxicological and climate impacts. Six types of means to embed environmental aspects into P&amp;R were identified: health technology assessment (HTA) integration, reimbursement criteria, pricing criteria, environmental classification, regulation and delinkage models. Most proposals were conceptual, whereas implemented or piloted examples focused on AMR\u2010oriented means. Reported challenges for implementation included challenges regarding data availability, comparability and verification; valuation and methodological integration; incentive design and cost distribution; and equity and political feasibility. Environmental aspects are not yet routine in medicine P&amp;R assessments due to a lack of standardised, verifiable product\u2010level data, appraisal methods and equity\u2010sensitive policy design.<\/jats:p>","DOI":"10.1111\/bcpt.70243","type":"journal-article","created":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T06:23:10Z","timestamp":1778480590000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Environmental Aspects in Price and Reimbursement Decisions of Medicines\u2014A Scoping Review"],"prefix":"10.1111","volume":"138","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6071-3297","authenticated-orcid":false,"given":"Lasse","family":"Alaj\u00e4rvi","sequence":"first","affiliation":[{"name":"School of Pharmacy, Faculty of Health Sciences University of Eastern Finland  Kuopio Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3593-3938","authenticated-orcid":false,"given":"Mirella","family":"Miettinen","sequence":"additional","affiliation":[{"name":"Law School, Faculty of Social Sciences and Business Studies University of Eastern Finland  Kuopio Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johanna","family":"Timonen","sequence":"additional","affiliation":[{"name":"School of Pharmacy, Faculty of Health Sciences University of Eastern Finland  Kuopio Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,10]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.2166\/9781789061826"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclepro.2024.142550"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.embor.7400307"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclepro.2017.09.247"},{"key":"e_1_2_11_6_1","volume-title":"European Union Strategic Approach to Pharmaceuticals in the Environment, COM(2019) 128 final","author":"European Commission","year":"2019"},{"key":"e_1_2_11_7_1","volume-title":"Pharmaceutical Strategy for Europe, COM(2020)761 final","author":"European Commission","year":"2020"},{"key":"e_1_2_11_8_1","unstructured":"Ministry of Social Affairs and Health Finland.Sosiaali\u2010 ja Terveysministeri\u00f6n Asetus L\u00e4\u00e4kkeiden Hintalautakunnalle Teht\u00e4v\u00e4st\u00e4 Hakemuksesta ja Hintailmoituksesta SDK 201\/2009 Finlex (2009)"},{"key":"e_1_2_11_9_1","unstructured":"World Health Organization.Medicines Reimbursement Policies in Europe World Health Organization Regional Office for Europe (2018) https:\/\/iris.who.int\/handle\/10665\/342220."},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1080\/1364557032000119616"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.7326\/M18\u20100850"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/bcpt.70159"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.banm.2020.09.037"},{"key":"e_1_2_11_14_1","first-page":"241","volume-title":"Ers\u00e4ttning vid L\u00e4kemedelsskador och Milj\u00f6h\u00e4nsyn i L\u00e4kemedelsf\u00f6rm\u00e5nerna","author":"Statens Offentliga Utredningar","year":"2013"},{"key":"e_1_2_11_15_1","unstructured":"E.van derGrinten A.Breure M.Lambooij andM.Lette Rijksinstituut Voor Volksgezondheid en Milieu RIVM2016Towards Balancing the Benefits of Pharmaceutical Care and Minimizing Its Environmental Harm: Identification of Potential Levers in the Medicinal Product Chainhttps:\/\/rivm.openrepository.com\/handle\/10029\/608988."},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jval.2015.11.008"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0266462316000581"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.4081\/idr.2017.6851"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.4081\/idr.2017.6836"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0266462318000351"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12940\u2010019\u20100531\u20101"},{"key":"e_1_2_11_22_1","unstructured":"A. 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