Pharmacist-led innovation enables recycling of more than four million medication boxes annually across public healthcare institutions
Singapore, 22 April 2026 - Tan Tock Seng Hospital (TTSH), the flagship hospital of NHG Health, is advancing sustainable healthcare at scale with a pharmacist-led innovation that will transform medication packaging across Singapore’s public healthcare system. This initiative is expected to make more than four million medication boxes recyclable each year by households.
Announced at TTSH’s Earth Day 2026 event, the initiative marks the first coordinated sustainability effort of its kind across all three public healthcare clusters. It reinforces the NHG Health cluster’s commitment to greener care and better health outcomes for the population.
The event was officiated by Dr Janil Puthucheary, Senior Minister of State, Ministry of Sustainability and the Environment.
Scaling Sustainable Pharmacy Practices Nationwide
Across Singapore's public healthcare institutions, millions of medication boxes are dispensed annually, many of which cannot be recycled due to their mixed-material design. These boxes are traditionally made of paper combined with a plastic viewing window, rendering them unsuitable for recycling. At TTSH alone, tens of thousands of such boxes are dispensed monthly.
To address this, TTSH’s pharmacists redesigned the packaging into a single-material paper box, removing the plastic component while preserving its durability and compatibility with automated pharmacy-dispensing systems. This means patients can dispose the box conveniently in the blue recycling bins located in housing estates and public spaces.
The redesigned boxes will be progressively adopted across public hospitals and polyclinics, starting with TTSH in April 2026. This marks a system-wide shift in how medication packaging is managed. If returned appropriately by patients, an estimated 4.36 million boxes could be recycled annually, reducing carbon emissions by 4,592 kg or roughly 24 round trips between Singapore and Bangkok[1]. The initiative also eliminates the use of about 1,837 kg of plastic each year, equivalent to 122,000 plastic bottles.
Professor Joe Sim, Group Chief Executive Officer, NHG Health, said: “Our responsibility goes beyond delivering excellent patient care. We must also do our part in ensuring that we deliver care that is sustainable for future generations. By redesigning the medication packaging at source, TTSH has reduced avoidable waste at system-level without compromising patient safety and operational efficiency. We commend TTSH for this effort, and in partnering with NEA to support public awareness and improve healthcare recycling practices nationwide.”
Extending Sustainability into Community Care: PRIME_MEDMatch
Beyond medication packaging, NHG Health is enhancing sustainability through responsible medication stewardship in the community. Its Population Health’s Community Health Teams (CHTs) and TTSH have piloted PRIME_MEDMatch (Project to Reduce the Impact of Medication Wastage on Environment in Community Care), a programme that safely redistributes eligible unused medications to suitable recipients.
During home visits, CHTs identify medications that are no longer required by patients and assess the medications against strict eligibility criteria. Only medications with intact original packaging, appropriate expiry dates and verified storage conditions are considered for redistribution. Common ones found suitable and frequently prescribed for chronic conditions, include gastrointestinal medications like omeprazole; laxatives like senna; and oral diabetes medications such as metformin.
All eligible medications undergo clinical review and are documented before being matched to patients with same prescriptions, in accordance with established governance protocols. This ensures traceability and clinical oversight for better patient safety.
Conducted from March 2025 to February 2026, the pilot programme:
- Collected 44,104-unit doses across 124 types of medicines
- Successfully matched 3,869 medicines to patients with corresponding prescriptions, reducing wastage
- Avoided approximately 89.5 kg of carbon emissions, equivalent to one return flight between Singapore and Kuala Lumpur1
- Recorded no adverse events following redistribution
The pilot also identified medication categories with higher carbon impact and generated insights on reducing oversupply and stockpiling. NHG Health is now exploring opportunities to scale the programme across the cluster, subject to further evaluation.
Recognising Staff Leadership in Sustainability
During the Earth Day event, TTSH launched its TTSH Sustainability Report and Roadmap. The Healthcare Sustainability Roadmap 2030 sets out the hospital’s approach to sustainable healthcare.
With a 2030 goal of improving energy and water efficiency by 10%, and reducing waste by 30% across the whole campus, TTSH is making steady progress. Its efforts are anchored in four key areas that will translate sustainability into practical actions across the hospital. (Refer to Annex 1 for details)
To recognise these initiatives, the hospital has introduced the inaugural TTSH Sustainability Awards, including the Eco Impact Award and the Sustainability in Everyday Practices Award. (Refer to Annex 2 for details)
One example is Ward 3A’s ICU, where nurses are actively recycling by segregating plastic aprons, irrigation bottles and other disposables for processing into resin. Since May 2024, recycling has grown from zero to 955 kg annually, avoiding an estimated 2,865 kg of CO₂e, equivalent to about 15 round trips between Singapore and Ho Chi Minh City[1]. Today, more than 85% of nursing staff are participating in this effort.
Adjunct Professor Tang Kong Choong, Chief Executive Officer, Tan Tock Seng Hospital, said: "Sustainability in healthcare is not driven by a single initiative. It is a mindset that shapes how we design care, make decisions, and use resources daily. While our Healthcare Sustainability Roadmap sets the direction, real impact comes from building a culture of staff-led innovation and empowering our people to rethink and redesign everyday processes, from packaging to prescribing. That’s how we achieve meaningful change at scale. It is also how we ensure that caring for patients extends to caring for the environment.
