Sterile or sustainable? The packaging of the future must be able to deliver both.

Packaging keeps syringes sterile, prevents implants from becoming contaminated, and protects prostheses from damage during transport. Without it, modern medicine would be inconceivable. But its downside is becoming ever more apparent: almost everything is single-use. Once opened, the packaging goes straight into the bin.

A glance at day-to-day life in the operating theatre illustrates just how much material accumulates in no time at all. A single operation may involve several dozen packaging units: sterile drapes, blister packs for screws and implants, films for instruments, pouches for catheters and infusion systems. By the end of the procedure, a full bin bag of plastic waste sits beside the operating table – all of it used once and discarded. Multiplied by millions of interventions worldwide, the result is a flood of waste that is proving difficult to contain.

The issue is also of economic relevance. According to a Markets & Markets study, the global market for medical device packaging was worth around 40 billion US dollars in 2024, with annual growth rates of six per cent. This growth is driven by the rising number of surgical procedures, an ageing population, and the trend towards increasingly packaging-intensive disposable products. Ecological considerations, however, continue to play only a minor role.

After every operation, a bag full of packaging waste is left behind © envato

The situation in hospitals is therefore ambivalent. On the one hand, packaging is indispensable to guarantee sterility and safety. On the other hand, its ecological side-effects are becoming an ever greater concern. In many cases, disposal takes place through incineration – a process that destroys valuable raw materials.

Other industries have already been forced to confront this challenge. With the European Green Deal and the Packaging and Packaging Waste Regulation (PPWR), Brussels is obliging food and cosmetics manufacturers to rethink their approaches. Packaging will in future have to be recyclable, meet minimum quotas for recycled content, and progressively replace fossil-based raw materials.

Research is responding accordingly. EU projects such as Circular FoodPack, involving the Fraunhofer Institute for Process Engineering and Packaging (IVV) in Freising near Munich, are demonstrating potential solutions. “Together with a consortium of numerous partners, we have shown that the use of recycled materials in closed loops is feasible – provided that labelling, sorting and reprocessing are properly aligned,” explains Swantje Eissing, Head of the Packaging Business Unit at Fraunhofer IVV.

Regulatory framework

In 2019, the EU launched its plastics strategy, built on three guiding principles: avoid, recycle, reuse. From this strategy emerged the Packaging and Packaging Waste Regulation (PPWR), adopted at the end of 2024 and in force since February 2025. “This has really put the pressure on companies seeking sustainable packaging solutions,” says Swantje Eissing.

The PPWR sets out requirements that are both strict and forward-looking. From 2030, EU-wide design-for-recycling standards will apply. Binding quotas for recycled content have been introduced – for example, 30 per cent in plastic beverage bottles – alongside gradually increasing quotas for plastic packaging as a whole. Even composite materials, which until now have been difficult to recycle, will be subject to stricter rules. Additives that impede recycling are to be progressively banned. The use of bio-based plastics is explicitly encouraged, provided they are recyclable and deliver an improved environmental footprint.

In this way, the EU is pursuing a dual ambition: on the one hand, to drastically reduce waste volumes; on the other, to stimulate the European market for secondary raw materials. Packaging design is being reimagined – away from disposable products and towards closed-loop systems.

Contact-sensitive medical devices, however, are still exempt from the toughest requirements due to their stringent sterility needs. For manufacturers, this is convenient in the short term. “So far, the big rush – the strong focus on sustainability – has not yet materialised in the MedTech sector to the same extent as in other industries,” Eissing observes. Aluminium laminates and complex plastic composites can continue to be used without regard for quotas. These materials are tried and tested, and they fit seamlessly into established production and sterilisation processes.

Medical technology between caution and bold moves

Few sectors are as tightly regulated when it comes to packaging as medical technology. Any change to material, design or barrier properties requires new validation procedures – involving significant costs and long timelines. “All these national approval processes are extremely time-consuming and costly for companies,” explains Swantje Eissing of the Fraunhofer IVV.

Swantje Eissing, Business Unit Manager Packaging at Fraunhofer IVV © Fraunhofer IVV

Against this backdrop, many manufacturers opt for what seems the safer route: sticking with conventional multilayer films – sandwich structures made from different plastics with varying properties and functions – or aluminium laminates. As long as the PPWR allows exemptions, there appears to be little incentive to invest in risky material changes.
But this strategy is not without its own risks. Once exemptions expire, there will be little time to adapt. Industry experts agree that medical technology will ultimately be obliged to comply, at the latest in the course of a PPWR revision or through accompanying national legislation.
Pressure is also mounting from another direction: the hospitals themselves. Increasingly, large institutions are factoring sustainability criteria into their procurement processes. Berlin’s Charité hospital, for example, includes procurement and waste as CO₂-relevant fields in its sustainability reporting and is driving sustainable procurement forward. In the United Kingdom, the National Health Service (NHS) has set a target of becoming climate neutral by 2045 – with packaging explicitly identified as part of the plan.
The dilemma is clear: those who wait save costs and effort today but risk running out of time tomorrow. Those who take the lead must bear high investment costs and navigate the validation of new materials – but in return secure the opportunity to set standards as pioneers. “There are a few who are taking a first-mover position, interested in exploring what opportunities exist,” says Eissing.

Coveris as a First Mover

One major packaging manufacturer taking a step forward is Coveris. The group, headquartered in Vienna, employs more than 4,000 people at 28 sites across Europe. Drawing on its experience in the food and consumer goods sector, Coveris is working to make the medical technology market more sustainable.
“There is still no compelling reason for our customers to switch to sustainable packaging solutions,” says Jan-Willem Bruijsten, Segment Director Medical at Coveris. “We do hear from nurses in hospitals that they would like to work in a more environmentally friendly way. But as long as it is not legally required for packaging to be recyclable or made from monomaterials, most medical device manufacturers do not consider the costs of such a switch to be worthwhile.”

Jan-Willem Bruijsten, Segment Director Medical at Coveris © Coveris

Nevertheless, Coveris is investing specifically in alternatives. At the centre of these efforts is the development of high-barrier monomaterials designed to replace today’s commonly used multilayer films or aluminium laminates. “These materials must retain all the key performance characteristics while at the same time enabling a more sustainable end of life,” explains Bruijsten. “We are learning from our R&D colleagues in the food industry what is required. We then transfer this knowledge – with some adjustments – to the medical field in order to meet the standards and barrier requirements that apply there,” Bruijsten adds.
For Coveris, sustainability is therefore part of the corporate strategy – and a lever to gain market share once the regulatory exemptions for medical technology are lifted.

Research pathways: bioplastics, recyclates, fibres

In their efforts to develop sustainable solutions, research institutes and industry are essentially pursuing three avenues: bioplastics, recyclates and fibre-based materials. Each of these approaches has potential but also comes with specific limitations.

Bioplastics are often seen as promising because they can replace fossil raw materials. “They can be a good alternative,” says Swantje Eissing, “but their availability is lower and the price point is higher than for fossil-based plastics. In addition, bioplastics need extra barriers, and especially in medical technology there is a big question mark over their sterilisation capability.”

For example, polylactide (PLA) softens at temperatures above 60 °C and is therefore unsuitable for steam sterilisation. Polyhydroxyalkanoates (PHA) are more flexible, but their production is expensive and not yet established at industrial scale. Polybutylene succinate (PBS) has good barrier properties but so far is produced almost exclusively for niche applications. Around the world, research projects are working to optimise these materials for medical use – in Finland, for instance, with BioMedPack, an EU-funded project that combines PLA with novel coatings to achieve sterilisation resistance.

The situation is also challenging when it comes to recyclates. For sterile applications, the highest purity and material consistency are required – conditions that mechanical recycling generally cannot fulfil. Chemical recycling offers an alternative, but its processes are energy-intensive and costly. According to industry analyses, by 2030 there is likely to be a recyclate shortfall of several million tonnes annually – a gap that chemical processes alone will scarcely be able to close. “This is a huge question for the entire industry,” explains Eissing. Major chemical companies are currently investing heavily. Until such approaches become widely available, however, medical technology will remain dependent on virgin materials.

A third avenue is fibres. In the Paludi project, for example, the Fraunhofer IVV investigated whether wetland plants could be used as a raw material for packaging. “We wanted to know whether these fibres could be processed into substrates that can be further refined,” explains Eissing. “Fibre-based packaging unfortunately has no inherent protective properties. That is why we also looked at what could serve as a raw material for bio-based coatings of the fibre material.”

Sustainable packaging produced from wetland plants using fibre-moulding and thermoforming processes © Fraunhofer IVV

All three pathways show progress – and all have their limitations. Bioplastics encounter hurdles when it comes to sterilisation capability and cost. Recyclates are scarce in the required quality. Fibre materials are more suitable for secondary and transport packaging. “On their own, these solutions are not yet an answer to the sustainability question,” says Eissing. Only in combination with innovative barrier coatings, digital product passports and an adapted waste-management logistics could a functioning circular system emerge.

Barriers in regulation and practice

As promising as the material innovations may be, the key problems lie in the regulatory environment and in clinical practice.

The Medical Device Regulation (MDR), in force since 2021, sets stricter requirements for documentation, risk assessment and clinical data. Even small changes – for example switching from a PA/PE film to a PE monomaterial film – can delay the validation process by years. The costs of the necessary tests, clinical evaluations and certifications are high. For small and medium-sized manufacturers, this is often a major obstacle.

Practical realities in hospitals also pose difficulties. They operate under time pressure, and surgical procedures are planned down to the minute. A packaging solution that is harder to open or requires additional steps is quickly rejected. “In the end, the time factor plays the biggest role in hospitals,” says Eissing. In this setting, safety and efficiency often outweigh ecological considerations.

Opening surgical packaging must be quick and seamless in day-to-day operating theatre practice © envato

Disposal also remains an unsolved problem. In Germany and many other countries, medical waste is routinely incinerated – regardless of whether it consists of contaminated materials or unused films. As a result, recycling concepts are practically ruled out. Pilot projects, such as at Freiburg University Hospital, have shown that separate collection would be possible – provided trained staff and clear legal requirements are in place. So far, however, such approaches remain the exception.

Looking back: from reuse to single-use In the past, reusable systems dominated everyday hospital routines. Surgical instruments, gowns, drapes or glass ampoules – everything was collected after use, cleaned or sterilised in autoclaves. Hospitals maintained their own dedicated departments with trained staff for this purpose – a complex but functioning system. A paradigm shift began in the 1980s. With the spread of HIV and hepatitis, concern about cross-contamination increased. Reusable packaging now came to be seen as a risk, even when properly sterilised. At the same time, single-use systems promised cost advantages: less staff needed for reprocessing, lower investment in sterilisation equipment, and faster workflows in clinical operations. Within just a few years, single-use products became the norm. Instruments arrived in plastic pouches. Textiles that had previously been reused were replaced with sterile disposable sets. Glass ampoules gave way to plastic syringes and containers. The piles of waste grew. In the United States, the move to single-use had already begun in the 1970s, when manufacturers marketed disposable products as hygienically superior. Single-use prevailed, not least because global manufacturers shifted their markets to standardised product lines. During the COVID-19 pandemic, medical waste from single-use products increased significantly – much of it generated by the packaging of masks, protective clothing and sterile medical devices.

Outlook: the next five to ten years

Experts expect that the European PPWR exemption for medical devices will not remain in place permanently. A future revision could bring the sector fully under its scope. For manufacturers, this would mean that within just a few years packaging would need to be recyclable and include a defined share of recycled content. With validation cycles lasting three to five years, there is little time to spare.

Swantje Eissing is convinced that solutions are ready. “In research we are already a step ahead and can point to solutions. I actually expect that in the next three to five years there will be more solutions coming into industrial application,” she says. She cites plastics containing recyclates in optimised monomaterial multilayer films and fibre-based solutions with improved barriers as candidates likely to make the leap from the laboratory to practice.

Jan-Willem Bruijsten assumes that mixed materials will eventually be completely banned. “Paper/ALU/PE packaging for products sensitive to UV and moisture will have to be replaced by a monomaterial film that meets these requirements.” Certain printing technologies could be used to provide additional protection – for example, through an ultra-thin barrier layer within the five- to 17-layer monomaterial structure.

The expert also expects “downgauging” of film thicknesses. This would reduce transport weight, material use, costs and the industry’s CO₂ footprint. Bruijsten: “Many packaging concepts are currently over-dimensioned for their application. Until now the approach has been: better too much than too little – costs and material consumption hardly mattered. But there are definitely still many optimisation possibilities.”

In Brussels, the European Commission is working on delegated acts to define minimum quotas for recyclates and to specify which materials will be excluded in future. At the same time, national health systems are formulating their own sustainability strategies. In Germany, hospital associations are calling for sustainability to become a mandatory criterion in procurement tenders.

Technological developments also point towards change. Harmonised labels are planned to provide transparency about the materials used in packaging and thereby facilitate recycling. AI-supported sorting could separate waste more precisely, enabling high-purity recyclates for medical applications. New barrier technologies – such as plasma or nano-coatings – are intended to make monomaterials more resistant to moisture and oxygen. And reusable systems for transport packaging could once again find their way into everyday hospital practice.

Several scenarios are possible. In the best case, manufacturers, hospitals and policymakers act together, develop market-ready monomaterials, adapt disposal processes and achieve closed loops. In the worst case, most delay action, regulation arrives abruptly, and supply security may be at risk. The most likely outcome is a mixed scenario: individual pioneers set standards, while the majority of the industry follows once regulatory pressure increases.

Over the next five to ten years, sustainable packaging could shift from niche to standard. Whether obligation or opportunity – the industry will have to act either way.

Sustainability as a driver of innovation – also at MedtecLIVE

The developments around sustainable packaging make it clear: medical technology is facing a transformation that goes far beyond regulatory requirements. Sustainability is becoming a driver of innovation – and thus a factor of competitiveness. This is precisely where MedtecLIVE comes in. From 5 to 7 May 2026 in Stuttgart, the central platform for the European medical technology sector will not only provide access to leading suppliers but also to the ideas that are shaping the future.

“Sustainable packaging solutions are no longer just a trend – they are an expression of technological responsibility and a key to the future viability of our industry,” says Silke Ludwig, Deputy Director MedtecLIVE. “Of course, we are still at the beginning: switching to monomaterials is technically demanding, comes with higher costs and entails regulatory challenges. And last but not least, healthcare facilities themselves must be ready to support this transition. That makes it all the more important for MedtecLIVE 2026 to showcase future-ready technologies and solutions – as a catalyst for innovation, transformation and sustainable competitiveness.”

Silke Ludwig, Deputy Director MedtecLIVE © NürnbergMesse

The debate on sustainable packaging illustrates how closely ecological responsibility and economic viability are intertwined. MedtecLIVE provides the space to advance these issues together with industry, research and users. Those who want to help shape the medical technology of tomorrow will find the right impulses here – and the right partners.