Disposable autoinjectors dominate modern medicine, but at what cost? As healthcare evolves, reusable autoinjectors offer a more sustainable, cost-effective and patient-friendly alternative. This article makes the case for a new standard: mechanical, reusable autoinjectors that cut waste, lower costs and deliver elegant design, without compromising patient care.
The environmental cost of disposable autoinjectors
We’ve engineered brilliance into five-second devices. Then we throw them away. Each year, more than 150 million disposable autoinjectors are discarded after a single use. That’s over 400,000 every day, made of oil-derived plastic, engineered metal springs and industrial-grade polymers. All used for roughly five seconds. Then binned.
In any other sector, this would be labelled what it is: an engineering failure. But in healthcare, we’ve normalised this waste in the name of convenience. It’s time to challenge that default. Because we now have the capability to build eco-friendly injection devices: safe, mechanical autoinjectors that are reusable. That means a durable body, a drop-in disposable dose cassette and a massive reduction in environmental impact per injection. The same clinical outcomes, but with a fraction of the waste.
This article argues for that shift. Not just on environmental grounds (though they are compelling), but as a systems-level rethink for regulators, device engineers and pharmaceutical decision-makers alike. A reusable future for autoinjectors is within reach, with promising platforms emerging that aim to meet clinical standards, cut waste and support environmental goals in drug delivery. So why are we still throwing away single-use devices?
The case against disposables
Reusable autoinjectors vs disposables: A carbon and waste lifecycle comparison
Reusable autoinjectors aren’t just “greener” in theory, the numbers back them. Lifecycle assessments are increasingly clear. For example, Phillips-Medisize’s [1] Aria platform has indicated over 50% reduction in device-related waste compared to traditional disposables. Factor in greenhouse gas emissions, shipping weight and landfill load, and the difference per dose becomes impossible to ignore.
Use one reusable autoinjector with up to 100 dosing cassettes, and you’ve removed 99 entire plastic-and-metal devices from the waste stream. That’s not just marginal improvement; that’s sustainable medical device design in action.
The problem isn’t just volume, it’s permanence. Disposable autoinjectors are complex hybrids of high-grade plastics, metals, residual drug and sharps. Once used, they enter specialised waste streams that are costly, carbon-intensive and environmentally risky.
Most are incinerated, releasing greenhouse gases and potentially hazardous emissions. Others end up in landfills, where durable plastics persist for centuries, sometimes breaking down into harmful microplastics. This isn’t a benign process. It’s a linear disposal system that drains finite resources and dumps the consequences downstream.
The result is a growing tide of medical waste that overwhelms disposal infrastructure and threatens ecosystems, from landfill sites to ocean floors.
We’re not just wasting material. We’re designing environmental hazard into the system by default.
Reducing cold chain burden with reusable autoinjectors
Smaller, cassette-only refills also simplify the logistics. This design advantage makes reusable autoinjectors ideal for reducing environmental and logistical burdens across global pharma supply chains. There is less packaging, less volume, less refrigeration space, less weight on planes, trucks and storage shelves. Multiply that across millions of global doses and the savings become significant.
This is where sustainable drug delivery systems create real value. A reusable autoinjector system, designed for repeat use, allows health systems to drive down the environmental footprint of cold chain logistics, a growing procurement concern.
The takeaway: single-use systems are designed for obsolescence. Mechanical reusables are designed for efficiency. And in an era of climate pledges, ESG mandates and public scrutiny, that matters.
Regulatory challenges facing reusable autoinjectors
While the environmental advantages of reusable autoinjectors are clear, they are not yet the regulatory norm. This seems to be largely because the regulatory system often leans towards approaches that are already well-established.
Regulatory bias toward disposables
Frameworks like the FDA’s 510(k) clearance pathway favour existing disposable autoinjectors and requires manufacturers to demonstrate “substantial equivalence” to predicate devices. Most existing predicates are disposable, so new disposable devices can follow a well-trodden, faster route to market.
Reusable alternatives must demonstrate:
- Mechanical durability over repeated use.
- Consistent performance under various environmental conditions.
- Resistance to contamination.
- Clear labelling for single-patient reuse.
- Compliance with ISO 11608 for performance and ISO 23908 for sharps safety.
Environment not (yet) considered
Crucially, environmental impact is not part of current medical device approval criteria. Unlike packaging regulations (where recyclability and carbon footprint are often mandated), device submissions do not currently include lifecycle assessment (LCA) data or carbon metrics. This results in:
- No formal incentive for greener design.
- Longer, more expensive approval timelines for reusables.
- Fewer regulatory precedents and higher risk for innovators.
Glimmers of change
Progress is starting. The 2017 FDA approval [2] of the AutoTouch® reusable injector for Enbrel Mini® (Etanercept) demonstrated that partially reusable systems can gain approval under current frameworks. In parallel, both the European Medicines Agency (EMA) and U.S. Food and Drug Administration (FDA) have released guidance [3] on reprocessing reusable medical devices, indicating growing openness to reuse under controlled conditions.
But to truly accelerate adoption, regulatory bodies must:
- Offer new pathways or designations for sustainable devices.
- Incorporate LCA and environmental data into reviews and approvals.
- Harmonise guidance globally to reduce duplication of effort.
- Incentivise models like single-patient reuse to address safety and contamination concerns while supporting sustainability.
Until then, the adoption of reusable innovation faces significant hurdles and proceeds more slowly than its potential suggests. Removing these regulatory friction points is essential if reusable innovation is to match its potential.
Designing reusable autoinjectors for usability and patient confidence
Usability isn’t optional. Patients relying on autoinjectors often live with chronic conditions like MS or arthritis. They may struggle with grip strength, dexterity or anxiety around injections. Any reusable device – or more specifically, the new wave of mechanical reusable autoinjectors – must match or exceed disposables in intuitiveness, reliability and safety.
Here’s how:
Drop-in dose
Dose cassette design should enable simple insertion. Ideally, a universal cartridge compatible with standard pre-filled syringes. A mechanical click or audible snap confirms placement, providing reassurance.
Minimal user steps
Loading the cassette can also prime the spring or reset the mechanism. Avoid any need for levers, dials or multiple motions. Great engineering should feel effortless to the user.
Consistent, low activation force
Activation and priming forces must remain low, particularly for users with reduced grip strength. While manufacturers are expected to determine suitable forces according to risk assessment and user studies, ISO 11608 provides technical guidance on test methods to demonstrate that forces are appropriate for the intended user population.
Sharps protection
Reusable autoinjectors must meet ISO 23908 to protect against needlestick injuries. This usually means a design where the needle and shielding mechanism are contained within the disposable cassette, keeping the reusable body free from biohazard exposure.
Hygiene by design
All drug-contacting components must be part of the disposable dose cassette. The reusable body should require no internal cleaning, only a simple wipe-down.
Reusable doesn’t mean complicated. It means engineered. Designed to deliver the same foolproof confidence as disposables, but without the waste.
Cost comparison: Reusable vs disposable autoinjectors
Let’s examine the economic considerations. Financial factors ultimately play a crucial role in determining strategy and investment, even when environmental benefits are significant.
Reusable autoinjectors may carry a higher upfront manufacturing cost. But spread that over hundreds of doses, and the per-injection cost plummets.
Table 1 below summarises how disposable and reusable autoinjectors compare across several factors.
| Factor | Disposable Autoinjector | Reusable Autoinjector |
| Cost per Injection | High – entire device cost incurred for every dose. | Lower – durable device cost spread over many doses (65–80% savings per dose). |
| Waste & Environmental | Significant plastic/metal waste for each use; high carbon footprint per dose. | Minimal waste per dose (small cassette); greatly reduced carbon footprint (50–80% lower). |
| Usability | One-step use (simple); no cleaning or setup aside from cap removal. | Slightly additional steps (insert cassette) but can be made intuitive. |
| Safety & Sharps | Built-in sharps protection (needle retracts or shields after use). | Built-in sharps protection must be engineered into cassette and device. |
| Regulatory Complexity | Well-trodden regulatory path (e.g., many predicates for 510(k)). Environmental impact not evaluated in approval. | Requires demonstrating durability, reusability safety, and labelling (e.g., single patient use only). Fewer prior examples, but guidance is emerging. |
Table 1. Comparison of disposable vs. reusable autoinjectors in sustainable drug delivery
The cost efficiency of reusable medical devices increases dramatically in chronic-use scenarios like diabetes, MS or RA. If a therapy is taken weekly or daily, the breakeven point is reached quickly.
On the other hand, if a treatment involves only a few injections (or an unpredictable dosing schedule), a reusable product might not reach its “break-even point” in cost or sustainability.
Device manufacturers and pharma companies must carefully model these scenarios. The sweet spot for reuse is in frequent, long-term therapies. For a device used only quarterly, the disposable vs. reusable trade-off might tilt back toward disposable due to the reusable not being utilised enough to offset its upfront impact. Understanding this balance is essential to decide when a reusable platform truly adds value.
Sustainable supply chains for reusable autoinjector platforms
Adopting reusable autoinjector platforms demands a new delivery model.
Reducing packaging, storage and cold chain costs
Reusable autoinjectors can also offer logistical advantages throughout the supply chain. A durable platform means pharma companies don’t need to package a full autoinjector with every dose. Instead, they can supply smaller disposable cassettes. This can simplify packaging and reduce storage space in warehouses, pharmacies and patient homes. It also potentially reduces cold chain costs thanks to less bulk per dose to refrigerate during transit. However, the supply chain must accommodate delivering the durable device (perhaps just once, with the first therapy) and ensuring patients have it when needed. Some pharma companies might bundle a reusable autoinjector in a starter kit and then provide drug refills separately.
Circularity and end-of-life strategy
Take-back programs and recycling schemes will become vital. Novo Nordisk’s[4] pen recycling pilot is an early example. Pharma companies will increasingly need credible lifecycle strategies.
Strategic implication
Device manufacturers may lose volume on full-device orders. But pharma companies gain:
- Differentiation.
- ESG compliance.
- Stronger scores in sustainability-based metrics.
- First-mover advantage in competitive markets.
The supply chain should be viewed not as a challenge, but as a strategic component for enabling new value
How reusable autoinjectors are becoming ESG procurement drivers
Health systems like the NHS[5] now score tenders on sustainability, not just cost and efficacy. In this context, a reusable autoinjector that reduces waste by 80% is not just a better product, but a procurement differentiator.
This is the real strategic unlock: environmental innovation becomes a commercial advantage. The question facing decision-makers is no longer if reusables are viable, but “why are we still buying disposable versions when better alternatives exist?”
What’s preventing widespread adoption of reusable autoinjectors?
Regulation, technology and cost are important considerations, but a significant factor influencing the pace of change is often organisational or systemic inertia.
Stakeholders have spent two decades scaling disposables. Processes are familiar. Teams are comfortable. Margins are predictable.
But the world is shifting.
- Patients care about sustainability.
- Regulators are opening doors.
- Procurement is changing its playbook.
Companies sticking with disposable medical device models risk falling behind shifting market expectations and missing the next wave of competitive advantage. Conversely, companies that are early to adopt reusable medical devices can gain a significant competitive edge, influencing market perceptions and helping to set new industry standards for sustainable healthcare solutions. Leading the change in reusable medical technology will define the future of sustainable drug delivery.
Conclusion: Redesigning drug delivery with reusable autoinjectors
The autoinjector status quo is no longer tenable. Engineering ingenuity has brought us to a tipping point where mechanical reusable autoinjectors can match disposables on safety, usability and reliability, while massively outperforming them on sustainability and cost-per-use.
But innovation without adoption is wasted. If we want a world where 10-year-olds starting lifelong therapies aren’t generating landfill into 2050, we need to change the model. Not later. Now.
The future isn’t single-use disposable. It’s reusable autoinjectors, built for repeat use, designed to protect both patients and the planet.
It’s time for industry leaders to stop waiting for permission and start building the future. Regulators must update the rules. Pharma must redesign the model. Engineers must build for reuse by default. The shift won’t happen by itself, it needs a deliberate push. The tools are ready. The case is clear.
Now is the moment to lead.
Make it mechanical. Make it reusable. Make it matter.