Why Sustainability Gets Left Behind in MedTech Innovation

Sustainability in medtech innovation is often treated as an afterthought. The reason is not that people are unaware of its importance, but that the system provides almost no incentives to make it a priority. Incorporating environmental goals means more work – redesigning devices, sourcing alternative materials and demonstrating compliance with stricter requirements. In a field where speed, regulatory approval and financial returns dominate, this extra work is usually seen as unnecessary. Companies that already struggle to get a product from concept to market are understandably reluctant to add layers of complexity that do not affect their ability to secure approval or reimbursement.

In private healthcare, the barriers are even stronger. Reimbursement codes are fixed, margins are tight and sustainability brings no financial reward. Within such systems, there can also be subtle but powerful pressures that run counter to environmental goals. The United States provides a striking example. Its healthcare system is highly fragmented, strongly profit-driven and oriented around fee-for-service reimbursement. In this context, clinicians and institutions often maximize earnings not by increasing patient numbers, but by lowering their own costs under fixed reimbursement structures. Disposable devices are attractive because they eliminate the need to invest in staff, equipment and processes to clean and maintain reusable alternatives. They are the cheapest option for providers, even when clinically unnecessary.

A particularly telling case is sleep diagnostics, where a new generation of home-use devices has built its business model around being disposable, despite the fact that reuse would be entirely feasible. The effectiveness and ease of use of these devices are real, but equally effective reusable alternatives exist. The preference for disposables comes largely from clinicians, who improve their margins by avoiding the overheads associated with cleaning and maintenance. This pressure cascades back to manufacturers, who respond by creating products designed for disposability. The environmental cost is therefore locked in from the outset, not because medicine requires it, but because the financial incentives of the system reward it.

This incentive structure also helps to explain why so many medical devices on the U.S. market are designed from the start to be used once and discarded. A disposable device carries less regulatory burden because the manufacturer does not need to demonstrate that it can withstand repeated cleaning. It also insulates hospitals from the need to invest in the infrastructure and staff required to manage reusable inventories. Both sides, therefore, find disposability convenient, even if the environmental cost is high.

What can be done to change this

Public healthcare systems, in some countries, offer a partial counterpoint. In the United Kingdom, for example, the National Health Service has explicitly tied its long-term strategy to net zero goals. This creates procurement requirements that, in theory, push suppliers toward greener products. Scandinavian countries have experimented with similar approaches, embedding sustainability criteria into tenders for medical equipment. These policies can help shift the market, since suppliers that fail to meet environmental standards risk losing access to large public contracts. Yet even in these settings, progress is uneven. Public systems are already under severe human resource and budget pressures, so environmental considerations often lose out to more immediate concerns about capacity and waiting lists. Procurement officers may sign up to carbon targets, but clinicians working under pressure are less likely to prioritize them when making decisions on the ground. The culture of disposability is difficult to dislodge once it has taken root.

If sustainability is to move from the margins to the center, it has to become a core target in the system. That means it must be built into how success is measured, either by rewarding companies that take it seriously or by punishing those that ignore it. Incentives could take the form of preferential reimbursement, tax benefits or procurement scoring that gives extra weight to environmentally responsible designs. Penalties might include higher levies on single-use products without clinical justification. Without mechanisms of this sort, sustainability will always remain secondary to immediate financial and clinical goals.

The role of patient education in extending the lifespan of medical devices

Patient education has a role to play, but it is not the main bottleneck. Well-informed patients handle and maintain their devices better, which extends product lifespan and reduces waste. Simple actions – such as correct cleaning of a CPAP mask or careful storage of an insulin pump – can reduce replacement rates. Education also empowers patients to report problems early, making refurbishment or repair more likely. Yet the decisive obstacles lie upstream in how devices are designed, approved and paid for. Even the best-informed patient cannot make a disposable device reusable, nor can they alter the reimbursement structures that drive manufacturers’ decisions. Patient education should therefore be seen as complementary rather than central.

The feasibility of developing reusable technologies for medical settings

The feasibility of developing reusable technologies depends heavily on the technology and the clinical context. In some cases, reuse is impossible because of infection control and safety requirements tied to the intended use. For example, certain invasive catheters or needles carry intrinsic risks that make reprocessing unfeasible. In other cases, partial reusability is practical. An electronic core may be safely reused while the patient-contacting attachment is disposable. This model already exists in some monitoring devices, where sensors or electrodes are swapped out, but the processing unit is preserved. In still other cases, entire devices can be designed for multiple uses without compromising safety, provided adequate cleaning infrastructure exists.

What complicates this picture is the regulatory environment. Current frameworks demand extensive testing for reusable devices, even when their risk profile is no greater than that of comparable consumer products. This creates a high compliance cost that discourages companies from pursuing reusable pathways. Indirect regulations compound the problem. One example is the framework around packaging in Europe. Although not specific to medical devices, these rules can force manufacturers to discard packaging after a single use, even when it could safely be reused for the same patient across multiple procedures. Cost and compliance considerations, therefore, tilt the balance toward disposability, not because the device itself cannot be reused, but because the system treats packaging as waste by default. And the ever-present justification of patient safety can be invoked to defend this decision, even when the underlying risks are minimal.

It would be misleading to suggest that manufacturers are hostile to sustainability. In reality, most companies operate in an environment where every stakeholder pulls in a different direction. Regulators want rigorous testing, payers want low costs, clinicians want efficiency and safety and patients want access. The system rarely rewards long-term environmental responsibility. Faced with these pressures, companies naturally gravitate toward the path of least resistance, which at present means designing for disposability.

Real change will only come when regulation, reimbursement and procurement are aligned so that sustainability is no longer the harder option. If hospitals and insurers make sustainability part of their purchasing criteria, if regulators reduce unnecessary burdens for safe reusable components and if governments tie incentives to carbon reduction targets, then the balance will shift. The challenge is significant, but the opportunity is equally large. Medtech innovation has transformed healthcare over the past fifty years. If the right signals are given, it can also transform its environmental footprint over the next fifty.