Accelerate Associates specialises in early-stage medical technology market assessments and bespoke market research to support commercialisation and business development in STEM B2B markets.
In 2015, Accelerate conducted a depth market assessment for SageTech Medical where we assessed the market for a novel technology that enables the capture and recycling of waste volatile anaesthetic agents. As we near the 10th anniversary of the technology market assessment report, this case study reflects on our early research findings and celebrates the technology’s commercialisation journey so far.
SageTech Medical has developed a safe, sustainable, and easy to use solution to tackle the problem of pollution from waste volatile anaesthetic gases.
Inhalational anaesthetic agents are potent greenhouse gases, which account for 2% of a typical hospital’s carbon emissions (1) and over 20% of the carbon footprint of surgical procedures (2).
The global warming potential (GWP 20) of volatile anaesthetics such as sevoflurane, isoflurane and desflurane have an impact of 508, 1401 and 3,714 times that of carbon dioxide, respectively (3).
SageTech Medical’s solution works by capturing waste anaesthetic agent breathed out by patients during operations by safely adsorbing it onto a specially developed filter contained inside a reusable capture canister, the SID-Can.
Two SID-Can filters reside inside a SID-Dock capture machine that integrates seamlessly with anaesthetic machines and hospital anaesthetic gas scavenging systems (AGSS).
When full, the SID-Cans are collected and emptied before being returned to hospitals for reuse. The recovered waste anaesthetic can then be recycled, ready to be used again.
Current market position
SageTech Medical’s gas capture system has been awarded the CE mark and its commercial product was launched into the UK market in 2023.
The technology is attracting significant interest across Europe and is used by private healthcare groups and early NHS adopter sites.
In addition to sales into human healthcare markets, the company is also supplying the veterinary practice market.
Market assessment key findings
Here, we present some of the intelligence identified in the original market assessment and compare it with today’s market conditions.
Research objective: Explore whether SageTech Medical’s technology may support the safe use of inhaled anaesthetic agents away from environments with active scavenging systems.
The market assessment: Consultant Anaesthetists identified scenarios where anaesthesia (such as intravenous anaesthesia) is used in settings with no scavenging system.
The study found anaesthesia is delivered in areas such as:
- Radiology (including X-ray, MRI, and endoscopy).
- Intensive care units
- A&E/Emergency rooms
- ECT (Electroconvulsive therapy) suites
- Paediatrics.
Nearly 70% of Consultant Anaesthetists interviewed said that it would be preferable, in some cases, to use inhalational anaesthetic agents (instead of intravenous anaesthetics) if scavenging or collection of waste gas were possible. For example, in Intensive Care Units or Emergency Departments.
Comments from Consultant Anaesthetists in the initial market study“If you have somebody with severe asthma, you might want to use volatile agents due to their broncho-dilating properties – if the situation was desperate for the patient. We don’t have scavenging in intensive care, so we sometimes use inhalational agents with filters to try to absorb the waste gas.”
“We have used sevoflurane without scavenging in children in CT and MRI in emergency situations.”
The 2015 market assessment also revealed a possible need for a rugged solution for military use. Although there are specialised anaesthetic machines designed for military use, modern military field hospitals tend to use anaesthetic machines as typically found in civilian hospitals. However, scavenging remains a concern in these settings.
The market today: Extensive testing of the filters typically used when scavenging systems are not available has found performance to be suboptimal at best. It is therefore unsurprising that SageTech Medical’s waste anaesthetic gas capture technology is generating interest not only from human healthcare providers, but also from the veterinary sector as the technology may provide a pathway to removing the need for scavenging.
In the case of the veterinary market, although the majority of anaesthesia machines used in the veterinary market are close relations to those used in human health, very few veterinary practices have access to a scavenging system.
SageTech Medical has developed a capture device for the veterinary market and early adopters are attracted to the technology, driven by environmental and health and safety concerns. Veterinary practices often vent waste gas through a window via a flue, and in some cases, a carbon filter technology is used to try to minimise exposure to staff.
Luke Rawlinson, Head of Commercial, SageTech Medical explains: “From our extensive performance and safety profile testing of filter materials, we know that the commonly used filter systems often do not perform adequately in terms of protecting staff.”
For staff who may be pregnant, inhaled anaesthetic agents present a real health and safety issue for veterinary practices. [4]
Research objective: Explore interoperability needs with existing systems
The market assessment: The assessment gathered intelligence regarding the anaesthetic machines and scavenging infrastructures used widely in the NHS. Findings concluded that many NHS organisations have standardised anaesthetic equipment across their real estate, with GE and Drager dominating the market for anaesthetic machines. The assessment also found 100% NHS Trusts surveyed were using active scavenging circle systems in their operating theatres. It was therefore concluded that SageTech’s technology must integrate seamlessly with existing systems to reduce barriers to market adoption.
The market today: SageTech Medical’s technology has been designed to fit seamlessly within existing systems and is anaesthetic machine-agnostic.
Scavenging systems are expensive to install, consume a lot of energy and require significant maintenance. SageTech Medical’s technology provides a pathway for reducing the use of scavenging systems in healthcare; significantly reducing energy consumption and safeguarding staff by safely collecting and storing waste anaesthetic agent.
The company has undertaken extensive safety testing and is working with regulators to explore deploying the technology as a safe alternative to using a scavenging system.
Research objective: Explore the cost, selection, and clinical use of inhaled anaesthetic agents
The market assessment: When investigating the cost of sevoflurane, desflurane and isoflurane and clinical practice, 70% (n=34) Consultant Anaesthetists reported that cost was influencing their choice of anaesthetic agent to some degree.
Due to the relatively high cost of desflurane, Accelerate found evidence of some NHS Trusts prohibiting the purchase of desflurane for routine use due to cost pressures. However, we found no evidence to suggest that any clinician would be prevented from selecting their anaesthetic agent of choice, for a specific case, if they felt it to be clinically appropriate.
In terms of how cost impacts anaesthetic agent selection, the market assessment found that isoflurane was relatively inexpensive in comparison to sevoflurane and desflurane and conflicting strategies were emerging amongst healthcare providers. Some were encouraging the routine use of isoflurane from a cost perspective whereas other organisations focused on the financial benefits of high patient throughput; selecting propofol, sevoflurane or desflurane to enable higher throughput of day case surgeries.
The market today: As of March 2024, the NHS has issued guidance for national decommissioning of desflurane for routine use. The driver for this change is due to the high global warming potential of desflurane. The guidance makes provision for desflurane to continue to be used in neurological procedures and for patients living with obesity.
European nations are taking similar approaches to reduce the use of desflurane in healthcare.
Research objective: Explore environmental concerns and awareness of the carbon footprint linked to anaesthesia
The market assessment: In 2015, concerns about the environmental impact of anaesthesia were minimal with 96% of survey participants stating that potential cost-savings associated with remanufacturing aesthetics agents would be the key driver for adopting the technology, rather than being driven by the need to reduce polluting emissions.
Accelerate’s research also revealed that the environmental impact of anaesthesia was virtually unmeasured in the NHS at the time, despite there being an awareness of carbon footprint reduction targets in the NHS. However, these targets were mostly associated with waste and energy consumption.
The market today: The impact of healthcare on global warming is now well reported. In 2019, a landmark report in the BMJ found that healthcare was responsible for 4.4% global net greenhouse gas emissions; concluding that healthcare is directly contributing to climate change.
Climate change threatens to erode good health and the well-being of mankind. It is linked to a number of health-related risks, including the spreading of insect-borne infectious diseases and the worsening of chronic respiratory and cardiovascular disease. Health service providers around the world are working to reduce harmful emissions and the carbon footprint of healthcare.
The COP28 meeting (December 2023) released its first ever declaration to place health at the heart of climate action. Nearly 200 nations agreed to the need to transition away from fossil fuels and identified anaesthesia, transport, and imaging processes as key areas of concern in healthcare systems.
New EU F-gas Regulation (EU 2024/573) requires reporting and prevention of F-gas emissions, with increasing penalties for non-compliance.
Luke explains: “New F-gas regulation in Europe requires reduction and capture of waste anaesthetic gas. As of January 2026, penalties will come into effect in Europe to encourage compliance.”
F Gas Regulation Regulation (EU) 2024/573 of the European Parliament and of the Council of 7 February 2024 on fluorinated greenhouse gases, amending Directive (EU) 2019/1937 and repealing Regulation (EU) No 517/2014 Paragraph 27. When desflurane is used as inhalation anaesthetic that very potent greenhouse gas is released. In light of the availability of less potent alternatives the use of desflurane should be permitted only where alternatives cannot be used for medical grounds. Where the derogation to permit its use applies desflurane should, like all other gases, be captured and the healthcare institution should keep evidence on the medical justification.
In the UK, desflurane was withdrawn from use by NHS Scotland in March 2023(5), and NHS England in March 2024(6) which has given rise to concerns about how best to decommission retained desflurane in vaporisers. Although it is possible to empty vaporisers by flushing the agent through the anaesthetic machine, the agent would simply be vented via the scavenging system into the atmosphere which would be detrimental to the environment and come at a significant carbon-equivalent footprint.
SageTech Medical’s technology captures desflurane, sevoflurane and isoflurane and provides a pathway to a circular economy for anaesthetic gases where waste anaesthetic gases are reclaimed and recycled from the capture devices.
The SID-Dock is an efficient means of capturing desflurane when vaporisers are flushed at high concentrations and fresh gas flows.
Manchester University NHS Foundation Trust (7)
The capture technology’s performance has been independently assessed by Manchester University NHS Foundation Trust (7), Newcastle upon Tyne Hospitals NHS Foundation Trust (8) and Guy’s and St. Thomas’ NHS Foundation Trust (9) with all parties reporting high capture efficiency using the technology.
SageTech has invested significantly in the development of the technology to purify waste anaesthetic material for potential reuse.
Luke Rawlinson: “The recycling capability is in the process of scale up to industrial level; a regulatory requirement for licensing the remanufactured agents. Commercialisation of the technology is a stepped process. The current phases are focused on collection and recovery, to reduce the environmental impact of waste anaesthetic gas and to improve safety for personnel. The next phase will be the widescale recycling for future reuse of reclaimed waste anaesthetic agents by way of distillation and purification.”
Final thoughts
We have followed SageTech’s commercialisation journey with interest. The market assessment was completed when the concept was at the ideation stage, with only lab-bench results to indicate whether the technology would work.
Perhaps one of the most substantial projects delivered by Accelerate, we surveyed clinical, management, pharmacy, estates, and procurement personnel from more than 50 health providers in the UK.
Ultimately, we concluded that there was an opportunity for the technology to reduce the environmental impact of inhaled anaesthesia, to deliver cost savings to healthcare and to improve safety for staff in close proximity to patients receiving inhaled anaesthetics.
At the time, positive attitudes within healthcare towards climate change and the use of polluting hydrocarbons could best be described as fledgling, with only a few key opinion leaders voicing their concerns over the environmental impact of the hydrocarbons used in clinical practice.
In stark contrast today, the global health economy now considers climate change a very real threat to human health and policy makers are increasingly scrutinizing healthcare practices from the perspective of reducing carbon emissions and environmental pollutants.
There is a very close correlation between the original market assessment findings and products and services SageTech Medical has developed to date. We are excited to see SageTech Medical entering new markets and the positive impact their collection technology can deliver to the global healthcare economy.
References
- NHS England, Putting anaesthetic-generated emissions to bed https://www.england.nhs.uk/greenernhs/whats-already-happening/putting-anaesthetic-generated-emissions-to-bed/
- Royal College of Surgeons, Surgery and the NHS Carbon Footprint https://publishing.rcseng.ac.uk/doi/pdf/10.1308/rcsbull.2020.152
- Bupa Healthcare: Preventing Pollution From Waste Anaesthetic Gases https://www.sagetechmedical.com/wp-content/uploads/2024/04/Bupa-Case-Study.pdf Accessed 28.05.24
- Nelson O, Greenwood E, Simpao AF, Matava CT. Refocusing on work-based hazards for the anaesthesiologist in a post-pandemic era. BJA Open. 2023 Oct 25;8:100234. doi: 10.1016/j.bjao.2023.100234. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10630594/
- Scottish Government. Making the NHS More Environmentally Friendly. 2023. https://www.gov.scot/news/making-the-nhs-more-environmentally-friendly/ (accessed 19/03/2023).
- NHS England. NHS Standard Contract 2023/24 Service Conditions(Full Length). 2023. https://www.england.nhs.uk/wp-content/uploads/2023/04/03-nhs-standard-contract-fl-scs-2324.pdf Accessed 28.05.24
- Shiralkar S, Field E, Murphy E, Shelton C. The role of volatile capture technology in desflurane disposal from decommissioned vaporisers. Anaesthesia. 2023 Oct;78(10):1298-1300. doi: 10.1111/anae.16044.
- Gandhi J, Baxter I. Efficiency of inhaled anaesthetic recapture in clinical practice. Comment on Br J Anaesth 2022; 129: e79–81 https://doi.org/10.1016/j.bja.2023.02.013
- Vaghela M, Kay RH, Jones L, Greig P. Inhalational anaesthetics: an assessment of agent delivery and capture. Anaesthesia. 2023 Jun;78(6):784-785. https://doi.org/10.1111/anae.15981
Philippa Bevan has over 25 years commercial and public sector experience in marketing, market research and product management spanning the education, laboratory, medical device, technology transfer and packaging industries. Philippa has a BSc (Hons) in Microbiology and Virology and is a Chartered Marketer.
