RT Journal Article
SR Electronic
T1 Journey of a pill
JF Canadian Family Physician
JO Can Fam Physician
FD The College of Family Physicians of Canada
SP 263
OP 269
DO 10.46747/cfp.7104263
VO 71
IS 4
A1 Kaur, Harjas
A1 Parascandalo, Fiona
A1 Krantzberg, Gail
A1 Ko, Emma
A1 Mathur, Neha
A1 Gill, Amanjot Singh
A1 Razack, Falisha
A1 Sergeant, Myles
YR 2025
UL http://www.cfp.ca/content/71/4/263.abstract
AB Objective To estimate the global journey of a generic clonazepam pill to map steps of production, distribution, and disposal.Data sources PubMed; Google Scholar; industry and market reports; gray literature; pharmaceutical databases (eg, PharmaCompass); export records; pharmacies in Hamilton, Ont; industry professionals and leaders such as pharmaceutical company vice presidents, professors, a supply chain insurance company, and sustainable procurement consulting companies; and an international not-for-profit company.Study selection Data related to clonazepam’s standard pharmaceutical production process, life cycle system boundaries, and most probable production locations were included in this review.Synthesis This study depicts the estimated journey of a clonazepam pill's production and distribution, with the prescription being filled in Vancouver, BC. It begins with the extraction of salts to produce the active pharmaceutical ingredient. The main centres for clonazepam’s active pharmaceutical ingredient and excipient salt extraction and production are in India and China. Quality testing and stocking occur elsewhere, such as within the European Union. The product is then shipped back to India for the next manufacturing stages. Excipients are shipped from China to India and are incorporated into formulation and tableting. The product is then sent to global markets for the final stages of pill formation and regional distribution. After shipment through Europe and Asia, the journey continues through several locations within the United States, specifically New Jersey, for the final stages of manufacturing. Once manufacturing is finalized in New Jersey, the pill is shipped to and repackaged in Tennessee for distribution and then sent to Canadian industry clusters, typically within the greater Toronto area in Ontario. Pills are then shipped to pharmacies and hospitals in Vancouver, BC, for consumer use. The total distance travelled in this scenario is approximately 63,162 km, not including the entire process of producing and shipping excipients or local retailer shipments.Conclusion Health care prescribing practices have tangible environmental impacts and manufacturers should continue to invest in operational streamlining to reduce greenhouse gas emissions.