Cost of Carbon in the Total Cost of a Healthcare Procedure: Example of Micro-Costing Study in a French Setting

Paul-Simon Pugliesi (), Hervé Frick, Stéphanie Guillot, Karine Ferrare, Catherine Renzullo, Alexandre Benoist, Serge Ribes, Guillaume Beltramo, Thomas Maldiney, Romain Schiphorst, Caroline Abdul Malak, Adrien Bevand, Laurie Marrauld and Catherine Lejeune
Additional contact information
Paul-Simon Pugliesi: William Morey Hospital
Hervé Frick: William Morey Hospital
Stéphanie Guillot: William Morey Hospital
Karine Ferrare: William Morey Hospital
Catherine Renzullo: Pharmacy, William Morey Hospital
Alexandre Benoist: William Morey Hospital
Serge Ribes: William Morey Hospital
Guillaume Beltramo: INSERM U1231
Thomas Maldiney: William Morey Hospital
Romain Schiphorst: William Morey Hospital
Caroline Abdul Malak: William Morey Hospital
Adrien Bevand: William Morey Hospital
Laurie Marrauld: University of Rennes, EHESP, CNRS, Inserm, Arènes – UMR 6051, RSMS (Health Services and Management Research) – U 1309
Catherine Lejeune: CHU Dijon Bourgogne, Inserm, Université de Bourgogne, CIC 1432, Module Épidémiologie Clinique

Applied Health Economics and Health Policy, 2025, vol. 23, issue 2, No 8, 265-275

Abstract: Abstract Background Economic evaluation aims to compare the costs and results of health strategies to inform public decision making. Although sometimes suggested, until now no national evaluation agency has recommended formally incorporating the cost of greenhouse gas (GHG) emissions generated by health interventions into the estimation of healthcare costs. Objective The objective of this study was to test and discuss the feasibility of estimating and including the contribution of GHG emissions cost to the total cost of a surgical intervention, with the example of robot-assisted total knee arthroplasty (RTA), using a micro-costing approach. Methods The study was conducted in June 2022 at the William Morey Hospital (France). Data regarding all of the resources (labor, medical equipment, consumables), as well as energy consumption, staff commuting and waste treatment were collected and valued from the hospital point of view. Greenhouse gas emissions were valued using a cost-effectiveness approach. Several sensitivity analyses were performed. Results The mean cost per patient of an RTA was estimated to be €4755.65, of which €152.64 (3.21 %) would be attributable to GHG emissions. The contribution of GHG emissions in the overall cost of a health intervention was highly dependent on the convention used for the price of carbon. Conclusion Despite persistent theoretical and practical challenges, adding the estimation of GHG emission costs in the economic evaluation of health interventions may provide institutional decision makers with information that allows them to allocate the public healthcare resources more efficiently.

JEL-codes: I18 Q52 (search for similar items in EconPapers)
Date: 2025
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DOI: 10.1007/s40258-024-00933-w

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