The report concludes that PFAS in medicine is not essential for many treatments currently available to patients. Researchers found that PFAS-free active pharmaceutical ingredients already exist for the majority of medicines examined, creating new opportunities to reduce the environmental impact of pharmaceuticals while maintaining therapeutic effectiveness.
The findings are expected to support healthcare professionals in choosing PFAS-free medicines where clinically appropriate and encourage pharmaceutical companies to consider environmental performance much earlier in the drug development process.
The research also comes as European regulators continue evaluating potential restrictions on PFAS across multiple industries.
Most PFAS medicines already have alternatives
The research team, led by Professor Michael Müller from the University of Freiburg’s Institute for Pharmaceutical Sciences, assessed active pharmaceutical ingredients classified as PFAS under the definition established by the Organisation for Economic Co-operation and Development (OECD.
Researchers analysed 111 active ingredients used in human medicines alongside 28 used in veterinary treatments.
Their assessment found that 87% of human medicines containing PFAS structures already have PFAS-free alternatives available for the same medical indications. Among veterinary medicines, 65% were found to have equivalent alternatives without PFAS properties.
For most of the remaining human medicines included in the study, researchers also identified PFAS-free replacements currently under development, suggesting the range of environmentally preferable treatment options is likely to expand further.
The report indicates that, in many cases, fluorinated chemical structures are not required to achieve the intended therapeutic effect.
Why PFAS are used in pharmaceuticals
PFAS compounds are widely used because they improve the stability of medicines and influence how active ingredients are distributed throughout the body. These characteristics can enhance pharmaceutical performance during treatment.
However, the same chemical stability that benefits medicines also creates environmental challenges once the compounds enter ecosystems after being excreted by patients.
Unlike many other substances, PFAS degrade extremely slowly, allowing them to persist in soil, rivers and groundwater for extended periods. Some PFAS compounds can also break down into long-lasting transformation products, including trifluoroacetic acid (TFA).
According to the report, more than 80% of the PFAS active ingredients examined have the potential to generate TFA. Because TFA remains in the environment, moves through the water cycle and is regarded as toxic to reproduction, researchers highlight it as a growing environmental concern.
Importantly, the report stresses that authorised medicines containing PFAS do not present an immediate safety risk to patients.
These medicines undergo extensive testing before receiving regulatory approval, and the study focuses on reducing environmental impacts rather than questioning their clinical safety.
New guidance for prescribing and drug development
The findings could influence prescribing decisions, particularly when patients begin new treatments.
The German Environment Agency plans to integrate the new research into its Environmental Pharmaceutical Index, making it easier for doctors and pharmacists to identify medicines with lower environmental impacts where suitable therapeutic alternatives exist.
The report also provides direction for pharmaceutical researchers by demonstrating that environmental considerations can be incorporated into medicine design without necessarily compromising effectiveness.
Rather than relying on PFAS during drug development, companies may increasingly explore alternative molecular designs that deliver comparable medical benefits while reducing the release of persistent chemicals into the environment.
Relevance for future European regulation
The study arrives as the European Chemicals Agency (ECHA) continues its scientific assessment of a proposed European Union-wide restriction on PFAS.
Active pharmaceutical ingredients have so far been exempt from the proposed restrictions because they have been regarded as essential for healthcare. However, the new evidence suggests that environmentally preferable alternatives are already available for many applications.
The scientific assessment is expected to conclude by the end of 2026, after which the European Commission is anticipated to present draft legislation in 2027.
If adopted, the findings could strengthen efforts to reduce PFAS in medicine while supporting the development of pharmaceuticals that balance clinical performance with improved environmental sustainability.
