Product stewardship is a product centred approach to environmental protection. It encourages companies to adopt life-cycle thinking and requires all stakeholders from manufacturers, distributors and consumers to reduce the environmental impact of products. Reducing the environmental impact of Novo Nordisk’s products can be done in a multitude of ways through reducing use of toxic substances, designing for reuse and recyclability, and creating take-back programs for products. Increasingly, there is a trend to close the loop on the product life-cycle by placing responsibility for safe and environmentally sound disposal of products on the manufacturers. Governments are introducing legislation to ensure the sound disposal of products at the end-of-life by making producers responsible for the products following disposal. In the EU, the new waste electronics and electrical directive (WEEE) requires companies to take-back electronic products which also include medical devices. Devices used as analysers are also included in the Directive. Regulations similar to the WEEE are currently being discussed in Asia as well. For Novo Nordisk, the WEEE directive has implications for existing glucose monitoring devices such as InDuo® and Innovo®. Novo Nordisk has to accept responsibility of the products at the end-of-life and therefore has to frame appropriate cost efficient responses. Another issue relating to product stewardship is the safe and environmentally sound disposal of prefilled devices. Novo Nordisk’s diabetes strategy focuses on upgrading patients from human insulin towards analogues and therefore towards prefilled devices such as FlexPen®. As a responsible company, it is important to develop strategies to ensure safe and environmentally sound disposal of these prefilled devices. Pharmaceuticals in the Environment are another issue pertaining to product stewardship. This is relevant for Novo Nordisk oestrogen related hormone products. In recent years it has been learned that, when pharmaceuticals are administered to patients, some of the active pharmaceutical ingredient (API) may not be completely metabolised (biochemically altered and inactivated). These non-metabolised portions are generally excreted through the urine and find their way into sewage systems where they are transported to wastewater treatment systems that remove most of the pharmaceutical residues. However, extremely low concentrations may pass through the wastewater treatment plant and be discharged to the environment. Despite low concentrations, low level effects have been observed in aquatic organisms. | 
