How digital tools can maximize sustainability in clinical trials

Clinical research is essential for medical progress – but it comes at a steep environmental cost. If the global healthcare sector were a country, it would rank as the fifth-largest greenhouse gas emitter, accounting for roughly 4–5% of worldwide emissions.

Within that, the pharmaceutical and biotech industry produces hundreds of millions of tons of CO₂ annually. A single late-stage clinical trial has an average carbon footprint on the order of 78 tons CO₂-equivalent (the range can top 100 tons). These emissions stem from energy-intensive lab work, global trial logistics, the manufacture and shipping of drugs and materials, and extensive travel by both patients and staff.

In short, today’s clinical trials literally carry the weight of a small country’s carbon output. Faced with this reality, the life sciences community is rallying to “rethink how we design and run our trials” in a more climate-conscious way.

At a recent DayOne Open Mic panel on the topic, experts from across the industry explored how digital innovation can help square the need for rigorous clinical research with urgent sustainability goals. The consensus: smarter use of digital tools – from remote trial technologies to data-driven efficiency measures – is already yielding win-win solutions that make trials greener and better. As Juergen Wieland, Development Sustainability Lead at Novartis, put it, “the biggest incentive to work on sustainability is our intrinsic need to ensure planetary and human health are thought together. There is just no healthy human being on a dead planet.”

One of the clearest opportunities to shrink a trial’s carbon footprint is to reduce the need for travel. Patient and staff travel can comprise the single largest emissions source in a study – an estimated 30–60% of a trial’s CO₂ output comes from participants driving or flying to sites, and from monitors (CRAs) traveling for on-site data checks.

During the COVID-19 pandemic, the industry accelerated the adoption of decentralized clinical trials (DCTs), using digital tools to bring studies to patients instead of always bringing patients to centralized sites. “Telemedicine allowing patients to participate from home reduces a lot of travel – and it’s good for patients, especially those with limited mobility,” noted Linus Kao, CEO and founder of Skyvor Medical. Digital health technologies like secure video visits, remote monitoring devices, and direct-to-patient drug shipments can replace many in-person visits. The environmental benefit is intuitive: fewer car and airplane trips mean fewer emissions.

Regulators are now on board as well. The U.S. FDA and the European Medicines Agency have recently issued guidance to facilitate decentralized trial elements in study protocols. This regulatory support, combined with rapid advances in telehealth and wearable sensors, has enabled sponsors to rethink trial design with an eye to both patient convenience and sustainability. For example, electronic informed consent and at-home nurse visits (areas explicitly encouraged by the EMA’s 2022 recommendation) mean that certain trial procedures can be done in a patient’s living room instead of a distant hospital. Each avoided trip not only cuts carbon; it also makes trial participation less burdensome, potentially improving recruitment and retention of volunteers.

Kao emphasized that digital decentralized tools have matured quickly: “During COVID we often said it was slow to adopt digital technologies, but a lot has changed. The FDA and EMA put out clear guidance by 2022 on using digital health tech for decentralized trials, and how that can reduce the carbon footprint.” According to Kao, travel and logistics together account for as much as 60–75% of a typical trial’s emissions, so even partial virtualization of a study can yield significant reductions. For instance, a remote telemedicine visit or home sensor can substitute for an on-site appointment that might have required a patient (and possibly a caregiver) to drive several hours. Beyond cutting carbon, these approaches often make trials more inclusive and patient-friendly, enabling people who live far from research centers to participate.

However, the panelists also cautioned that decentralization is not a panacea for all trials. Implementing a full suite of remote technologies can add complexity. Smaller biotech companies running lean early-phase trials may lack the budget and bandwidth to manage multiple new digital systems for e-consent, home nursing, remote data capture, etc. In those cases, the priority is using targeted digital strategies to streamline the trial process rather than force a fully virtual model. “For the smaller-scale trials, speed is the key,” Kao explained. “Any digital solutions that can reduce the timeline will also reduce a lot of carbon footprint.”

In practice, that might mean using data analytics to optimize site selection and patient recruitment – enrolling the right patients faster so that fewer clinic visits and less idle trial time accumulate. Or it might mean employing an all-in-one digital platform (instead of a patchwork of tools) so that trial teams can work more efficiently. The underlying principle is that a faster trial is a greener trial: every day shaved off the timeline is one less day of energy consumed by trial sites and equipment, one less day of data servers running, and often one less opportunity for material waste.

Beyond travel, trial logistics and material waste are another major contributor to the environmental footprint. Clinical trials involve moving a lot of physical goods – from investigative drugs and lab kits shipped around the world, to paper documents, to the disposable supplies used in administering treatments and tests. Until recently, these processes were rife with inefficiencies. Wieland recounted how a few years ago, Novartis examined its global clinical supply operations and discovered startling waste in the system: overproduction of trial drug doses, oversized shipments, and large volumes of unused lab kits that would ultimately be thrown away. Much of this stemmed from well-intentioned caution – for example, manufacturing more investigational product than needed “just in case,” or sending every site a full batch of pre-labeled sample collection kits for every patient “just in case” they might be used. The result, however, was mountains of expired pills and unused materials.

Here is where digital tools and better data have made a profound impact. By implementing advanced supply chain management software, analytics, and forecasting models, Novartis was able to bring unprecedented transparency and control to its trial operations. Wieland described how connecting real-time data on patient enrollment, drug inventory, and site needs allowed the company’s teams to optimize shipments and production in ways previously not possible. “We saw a lot of opportunities to first bring transparency into the demand and inventory levels, and [by] reducing the total volume of drug for clinical use we cut technical demand by more than two-thirds in a few years’ time,” he said. In practice, that means far less medication being manufactured only to never be administered – saving energy, resources, and cost.

Likewise, Novartis and others streamlined how often and how full their shipments travel. With better planning, consolidated shipments became the norm: sending larger batched deliveries rather than many small parcels. Over about two years, Novartis managed to reduce its annual clinical trial shipments by more than 50% (from around 86,000 down to under half that number). Fewer shipments translate directly to lower transport emissions, not to mention financial savings. As Wieland noted, sustainability efforts often reveal hidden inefficiencies. When you fix them, “we obviously see a lot of cost savings linked to that. We were able to make the business case in the company.” In fact, one initiative – switching from single-use thermal packaging to reusable insulated shipping boxes – has already been used in over 100,000 shipments, avoiding piles of Styrofoam waste and saving tens of millions of dollars.

Waste reduction is a clear area of win-win outcomes. A leaner trial supply chain not only cuts emissions and waste disposal costs but also makes trials faster and more reliable. The panel discussed creative programs to repurpose unavoidable surplus – for example, donating unopened expired kits for veterinary or training use – but the ultimate goal is to generate less excess in the first place.

Here too, cross-industry collaboration and standards can help. Wieland mentioned the idea of standardizing lab kit components (like blood draw tubes) across sponsors, so that a site isn’t stuck discarding an entire custom kit just because one tube type expired. If all companies draw blood with, say, a common 10 ml tube, those supplies could be pooled or shared rather than wasted per trial. Such coordination requires industry agreement, but it’s the kind of systemic change that digital inventory tracking and data sharing platforms can enable soon.

Crucially, what makes these improvements possible is the data-driven visibility that digital tools provide. It’s difficult to eliminate waste you can’t see. By digitizing inventory management and using sensors or RFID tracking on shipments, trial managers now have granular data on where materials are, how they’re used, and where the bottlenecks or waste points occur. Those insights allow for continuous optimization. And success begets success: once teams see that smarter logistics can dramatically cut costs and carbon, it creates momentum to tackle other areas (for instance, the 100,000+ biological sample shipments that large trials generate, which involve refrigerated transport and lots of packaging). In Wieland’s experience, “the more we make it easy and attractive – and even cost-saving – to choose the sustainable option, the faster we can scale up these solutions.” Sustainability doesn’t have to mean sacrifice; often it means embracing operational excellence, doing more with less.

Digital technology’s greatest contribution might be its power to illuminate problems and unlock human ingenuity. “If you put data in the hands of researchers, they’re going to use it,” said James Connelly, CEO of My Green Lab, underlining that scientists by nature respond to evidence. Historically, many sustainability challenges in R&D were “invisible” or not measured – think of all the ultra-cold freezers humming in laboratories or the mountains of single-use plastics being discarded.

Now, new tools are making the environmental impact of research measurable and transparent, which is spurring action. Connelly’s organization, for instance, developed an Impact Calculator and Certification program for labs that allows scientists to input their equipment and practices and get a quantified readout of their energy, water and waste footprint. When AstraZeneca rolled this out to over 100 research labs last year, the results were eye-opening: simple changes like raising ultra-low freezer temps from -80°C to -70°C (without compromising samples) and closing fume hood sashes when not in use translated into a 5× return on investment in energy savings within one year. In Connelly’s words, “a green lab isn’t a more complicated lab – it’s just a more efficient operation. It’s about pursuing operational excellence…running it as efficiently as possible, and then you have a better lab.”

This ethos applies directly to clinical trials. Many trials rely on networks of diagnostic labs and data centers that consume significant resources. By monitoring and optimizing those facilities with digital solutions, companies can drive down the footprint of each test or data transaction. Cloud-based platforms now allow R&D teams to model different scenarios – for example, simulating how switching to renewable energy at data centers or consolidating lab analyses in fewer locations might reduce emissions – and make decisions informed by that analysis. Wearable sensors and remote data collection can also cut down on ancillary resource use; for instance, continuous monitoring might catch issues earlier and prevent unnecessary procedures or hospital visits.

Another exciting frontier is the use of AI and computational modelling to redesign how trials are conducted. Advanced analytics can sift through troves of data to identify the most efficient trial designs, optimal site locations, or even predict enrollment challenges before they happen. Wieland mentioned that Novartis is investing in AI-driven tools to improve site and patient selection – speeding up recruitment and ensuring trial populations are representative without endless global site expansions. More ambitiously, machine learning could help create “digital twins” of trials – virtual simulations of the trial process to experiment with changes in real time. While true end-to-end virtual trials remain a future vision (and current regulations still require actual patients and control arms), AI is already helping in narrower scopes, such as analyzing historical data to replace or reduce placebo arms. If a company can use existing patient data to avoid enrolling 100 extra people on placebo, that’s 100 people who don’t need to travel, and a leaner trial protocol overall.

The panel agreed that digital innovation and sustainability go hand in hand. Often, the greener approach is simply the more modern, efficient approach. “Doing better science often is more efficient,” Connelly noted. Tools that improve data quality or automate manual processes not only save time and money – they prevent waste and repetition. Electronic data capture, remote monitoring, AI-driven data analysis: all reduce the need for paper, redundant tests, physical storage and archiving. And importantly, they generate metrics. “That which gets measured gets managed, and eventually improved,” as they say.

A recurring theme in the discussion was that no single company or stakeholder can crack sustainable trials alone – nor do they need to. Cross-industry collaboration is accelerating progress by pooling knowledge and aligning standards. Wieland highlighted that major pharma players have been joining forces in pre-competitive initiatives like the Sustainable Healthcare Coalition and the Sustainable Markets Initiative’s health sector task forces. Competitors sit together to share best practices on everything from green clinical supply strategies to sustainable lab frameworks. The Innovative Health Initiative in Europe (a public-private partnership) is another venue where pharma, biotech startups, academia and regulators pilot new methods with an eye on both innovation and sustainability. These collaborations have already led to tangible outcomes – for example, the Low Carbon Clinical Trial Guide developed through the Sustainable Healthcare Coalition provides a common methodology for measuring a trial’s footprint and identifying “hotspots,” which companies can then target for improvement.

Regulators, too, are increasingly seen as partners in this mission. Not long ago, well-intended health regulations sometimes inadvertently hampered sustainability – such as rules that all drug packaging include paper leaflets, resulting in millions of printed pages that most patients never read. Now there’s movement to modernize those requirements (e-leaflets, anyone?) in line with environmental goals. Countries like Japan and Singapore have led the way by allowing electronic drug information via QR codes years ago, and Europe is testing similar approaches. More broadly, policy drivers are emerging that will reinforce corporate climate action. In the EU, for instance, new regulations taking effect in 2026 will require any environmental claims by companies to be backed up with hard data and third-party verification. This kind of policy shift will help separate real progress from greenwashing, and it underscores the value of the measurement tools and transparency the panelists championed.

Perhaps the most important ingredient is culture. Sustainability must become ingrained in the way trial teams operate day to day. One encouraging insight shared was that much of Novartis’s green trials effort started bottom-up – passionate employees across different departments volunteering ideas and pushing initiatives, long before there was a top-down mandate. Once small pilot successes were achieved, leadership support (and funding) followed, creating a positive feedback loop. Empowering those grassroots efforts with data and resources can turn a few isolated eco-champions into an organization-wide movement. And when leadership further ties sustainability to core business objectives (for example, including climate targets in management KPIs or linking cost savings to green projects), it cements the idea that “planet-friendly” also means “patient-friendly” and “business-friendly.”

Looking ahead, the consensus is that climate-conscious trial design will become the new normal. The health innovation ecosystem is uniquely positioned to lead on this front. “This industry has a culture of innovation and a mission of improving health,” Connelly observed. “We’re used to making long-term investments for society’s benefit. One of the most important contributions pharma can make now is to show that we can reach zero carbon while still delivering amazing medicines.” Achieving net-zero clinical trials will not happen overnight, but the momentum is building. Each success – a faster trial timeline, a reduction in waste, a new digital platform that eliminates unnecessary travel – is both a climate win and a proof point that it can be done.

The call to action for the sector is clear: step up and lead. As Wieland urged, “Don’t wait for your boss or the others. Find what contribution you can bring to the table.” Whether you’re a big pharma executive, a startup founder, a research nurse, or a regulator, there are practical steps you can take today: implement that digital tool, question that wasteful process, share your findings with the community, and demand higher standards where they matter. The technology and know-how to make trials more sustainable are advancing rapidly – but it will require collective will to implement them at scale.

In the end, climate action in clinical trials isn’t just about carbon accounting; it’s about rethinking innovation to be smarter and more responsible. As the panel’s discussion demonstrated, doing the right thing for the planet often aligns with doing the right thing for patients and science. Decentralized and data-driven approaches are already enhancing trial diversity and patient centricity. Efficiency measures are already cutting costs and speeding deliveries of new therapies. The greener path is truly the better path for healthcare.

DayOne, as an ecosystem catalyst, is committed to driving this conversation and supporting solutions at the intersection of healthtech and clinical trials. The growing movement to green our clinical trials reflects a broader transformation in healthcare – one where climate consciousness is embedded in innovation. By harnessing digital tools and collaborative ingenuity, we can ensure that the trials powering tomorrow’s cures leave a lighter footprint on the world. The challenge is urgent, but the opportunity is immense: to heal patients and protect the planet, one smart trial at a time.

Please note: This article was developed from the proceedings of the Open Mic: Next in Health event held on May 26, 2025, “Digital tools for sustainability in clinical trials.”

To learn more about this event series, register for our next edition, and sign up for our newsletter, check out the Open Mic page.