Many medicines containing per- and polyfluorinated alkyl compounds, known as PFAS, could be substituted with alternative active ingredients, according to a report released on June 30 by the University of Freiburg and commissioned by the German Environment Agency. The report highlights that doctors may soon prioritize prescribing PFAS-free medicines when therapeutically appropriate.
The study found that a large proportion of PFAS-containing active pharmaceutical ingredients used in both human and veterinary medicine could eventually be replaced by non-PFAS alternatives. Specifically, for 87 percent of identified human medicines and 65 percent of veterinary medicines containing PFAS structures, there are already existing active ingredients without PFAS properties available for the same applications. The research examined 111 human medicine active pharmaceutical ingredients and 28 veterinary medicine substances classified as PFAS under the Organisation for Economic Co-operation and Development's definition. Additionally, researchers reported that almost all remaining human medicines have PFAS-free alternatives currently in development.
Dr. Dirk Messner, President of the German Environment Agency, said, "The study's findings clearly show that environmental protection and healthcare need not be at odds with one another. The pharmaceutical industry already has enormous leverage in this area, right from the drug development process, to significantly reduce the release of persistent chemicals such as PFAS into our waterways and soil in future."
The report also provides insights for pharmaceutical research: it notes that for examined substances with known mechanisms of action, their effectiveness is not dependent on having a PFAS structure. Per- and polyfluorination is typically used to improve stability and distribution within the body but leads to environmental persistence once excreted. More than 80 percent of studied active ingredients have potential to break down into trifluoroacetic acid (TFA), which does not degrade in nature and is considered toxic to reproduction.
There is no immediate risk posed to patients from using medicines containing PFAS, since these undergo thorough testing before authorization. However, doctors can use these findings when starting new treatments to choose more environmentally friendly options if suitable.
The findings are expected to inform ongoing European Union regulatory discussions about restricting PFAS use; currently pharmaceuticals are exempt due to being considered essential. The expert report suggests reconsidering this exemption where viable alternatives exist.
