Assess carbon emissions
Use the Clinical Trials Carbon Calculator to compare scenarios and identify carbon trade-offs quantitatively before finalising protocol decisions. Data-driven design prevents costly environmental mistakes
Sustainable Trials by Design
Embedding environmental considerations into clinical trial protocols from the earliest planning stages
The most effective place to focus emission-reduction efforts is before a trial even starts: in the design phase. Building environmental considerations into early protocol development embeds sustainability by design, rather than retrofitting it after the protocol is finalised.
GUIDE | Aug 2026
Co-benefits
Applying a sustainability lens to protocol development often streamlines trials, reducing unnecessary visits, procedures, and paperwork, which lowers costs and participant burden.
It can improve patient retention and increase access as well as decreasing timelines and strengthening data quality. Sustainable trials support resilience over disruption, and build long-term regulatory and public trust in research.
Explore our resources to find real-world implementation cases of where applying a sustainable lens to protocol design has led to multiple co-benefits including cost avoidance and improved efficiency in trial operations.
Trade-offs
Decisions made to reduce carbon emissions can unintentionally shift them elsewhere or even increase the overall footprint. For example, reducing patient travel may increase medication shipping and staff travel.
Decarbonisation strategies should be applied where it measurably reduces patient, site, data and environmental burden, without shifting that burden elsewhere. Always view protocol changes holistically, and remember that patient safety and data integrity come first.
Use the Clinical Trials Carbon Calculator scenario functionality to compare design choices and understand carbon trade-offs before committing to a protocol.
Sustainable principles for clinical trial design & execution
Sustainable trial design rests on a eight principles that should inform every protocol or operational decision from the earliest planning stages.
Let's dig deeper
Embrace adaptive designs
Adaptive trial designs allow real-time adjustments based on accumulating data, modifying sample size or treatment arms in response to emerging evidence for faster, more efficient trials
Minimise patient and staff travel
Redesign visits, monitoring, and site logistics so fewer people need to physically move to deliver the same trial
Minimise waste
Design out unnecessary consumables, packaging, and oversupply at the protocol and forecasting stage, and divert what remains from disposal.
Consider digital and decentralise approaches
eConsent, eCOA, telemedicine visits, at-home nursing, direct-to-patient investigational product shipments, and other decentralised trial (DCT) elements may reduce patient travel burdens and site-visit frequency
Supply chain engagement
Streamline the manufacturing, distribution, and cold-chain logistics that move drug and materials to site
Efficient site operations
Reduce the energy, space, and material footprint of running the sites and facilities a trial depends on
Governance, incentives and culture
Navigating change can be tough. Embedding new processes into business as usual requires a robust infrastructure of process, training, tools, KPIs and governance to ensure lasting impact
Protocol sustainability checklist
A practical tool for reviewing your trial protocol, section by section, through a sustainability lens covering site selection, study design, IP and lab logistics, devices, travel, and monitoring.
Work through each topic area to identify opportunities to embed environmental considerations into your design while protecting patient safety and study integrity.
Remember that each trial is different and some questions will not be appropriate for your trial.
Caution: Decisions made to reduce carbon emissions can unintentionally shift them elsewhere or even increase the overall footprint. Use the Clinical Trials Carbon Calculator scenario functionality to compare design choices and understand carbon trade-offs before committing to a protocol.
