HQ Team
September 21, 2026: A study commissioned by Germany’s Federal Environment Agency (UBA) and carried out by a University of Freiburg team found that 87 percent of human medicines built around per- and polyfluoroalkyl substances, or PFAS, already have chemically viable, PFAS-free substitutes on the market for the same use. The finding lands just as the European Union moves toward one of the broadest chemical restrictions in its history, and raises an uncomfortable question: if safer alternatives already exist, why are PFAS-based drugs still being prescribed?
PFAS is an umbrella term for a family of more than 15,000 chemicals built around a carbon-fluorine bond so strong it barely breaks down in nature — the reason they are nicknamed “forever chemicals.”. Adding fluorine to a drug molecule slows metabolism (the body’s process of breaking a drug down for elimination), which stretches out its half-life and allows for less frequent dosing, while also improving how well a drug binds to its target and moves through the body. The approach has become so routine that roughly 40 percent of newly approved pharmaceuticals now contain fluorine in some form.
The study
The Freiburg team, led by pharmaceutical sciences professor Michael Müller, screened 111 active pharmaceutical ingredients used in human medicine and 28 used in veterinary products against the OECD’s definition of PFAS. For 87 percent of the human drugs and 65 percent of the veterinary ones, non-PFAS alternatives already treat the same conditions; for nearly all the rest, PFAS-free candidates are already in development. “Per- or polyfluorination is not strictly necessary” from a pharmacological standpoint, Müller said, since alternatives exist for almost every indication studied. The environmental stakes are what make the finding urgent: more than 80 percent of the PFAS drug ingredients examined can break down into trifluoroacetic acid (TFA), a byproduct that does not degrade, travels freely through the water cycle, and is considered toxic to reproduction. UBA president Dirk Messner called the results proof that “environmental protection and healthcare need not be at odds.”
Medicinal equipment norms
Not all PFAS in healthcare face the same scrutiny. In a September 2026 update, the U.S. Food and Drug Administration drew a sharp line between the small-molecule PFAS linked to environmental contamination and the large-molecule fluoropolymers — like PTFE, used in stents, catheters, pacemaker wire coatings and wound dressings that have been standard in devices for roughly 75 years. The agency says no substitute material yet matches fluoropolymers’ combination of lubricity, electrical insulation and biostability, and it has found no evidence linking them to patient harm after decades of monitoring, including an independent review of more than 1,750 studies.
So why hasn’t the industry switched already?
Scientific feasibility is only half the equation. Swapping an approved drug’s active ingredient means new safety and efficacy trials, fresh regulatory filings and reworked manufacturing lines, a process that can take years and tens of millions of dollars, even when a substitute already exists elsewhere in the market. Under the EU’s REACH chemical regulation, active pharmaceutical ingredients have so far been exempted from PFAS curbs precisely because they are treated as essential. Industry groups including the European Federation of Pharmaceutical Industries and Associations, Pharma Deutschland and Germany’s dental-industry association are now lobbying for that exemption to stay, warning that a blanket restriction could disrupt over 47,000 global marketing authorizations and put more than 600 essential medicines at risk; some are requesting a transition window stretching to 23.5 years.
The European Chemicals Agency’s Committee for Socio-Economic Analysis has been reviewing its draft opinion on the PFAS restriction through 2026, with a final scientific assessment due by year’s end and a European Commission legislative proposal expected in 2027. In the meantime, Germany’s UBA is folding the Freiburg findings into its Environmental Pharmaceutical Index, a tool meant to help doctors and pharmacists favor PFAS-free options when they are therapeutically equivalent. For now, that is a nudge rather than a mandate, leaving the gap between what pharma could do and what it is doing to close on the industry’s own timeline, not the environment’s.
