Scaling refrigerated networks for vaccines and biologics requires far more energy than ambient medicines, adding to healthcare’s carbon footprint. High energy and shipping costs compound the challenge. The cold chain—an uninterrupted temperature‑controlled supply from manufacturing to patient—is essential for biologics and vaccines and will continue to drive market growth. Using IQVIA audit data and NIH Daily Med, the authors identified 564 substances requiring cold‑chain storage and advocate greener logistics and localised manufacturing to meet ESG goals and maintain supply continuity.

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