What is Circular Economy? Understanding the 9R System

When I tell people I work in Regulatory Affairs and Circular Economy for MedTech, I’m often met with a blank stare.  Many people simply don’t know what circular economy is, let alone how it applies to MedTech.

When they do have an idea, they usually think it just means recycling. But it’s much broader than that.

That’s why I’m starting a short series of three blog posts exploring what circular economy means for MedTech:

1. What is circular economy and the 9R system?

2. Why the 9R system matters — even if you’re a founder buried in MDR.

3. Where the real opportunities lie for MedTech start-ups (including MDSW founders).

   
   

Let’s start with part 1.

If you’re already buried in MDR submissions and wondering why you should care about circular economy on top of everything else, stay with me. This series is designed to save you time, not to add to your workload. I’ll show you where circularity can help you avoid costly redesigns later on, and where it simply makes good business sense.

Healthcare has a significant waste problem. Roughly 80% of the sector’s carbon footprint comes from the production, transport, use, and disposal of single-use products and devices [1] and the healthcare sector uses an estimated 15 million tonnes of plastic each year [2].   

For an industry whose purpose is to protect health, that is an uncomfortable contradiction. For founders however, it represents a significant opportunity to innovate.

What the 9R System Actually Is

The most useful way to understand the circular economy is through the 9R system: A circle with ten strategies, ranging from R0 to R9, that rank the best ways to keep products, components and materials in use and reduce waste.

The lower the number, the more circular the strategy is and, in most cases, the more value it retains. Refuse and Rethink (R0–R1) preserve the greatest value, while Recycle and Recover (R8–R9) should be seen as last resort, used only when none of the higher-value strategies are feasible.

Here is what each of the ten strategies means, based on the original PBL framework [3]:

Category	R	Strategy	Description
Smarter product use and manufacture	R0	Refuse	Make product redundant by abandoning its function or by offering the same function with a radically different product
	R1	Rethink	Make product use more intensive (e.g. by sharing product)
	R2	Reduce	Increase efficiency in product manufacture or use by consuming fewer natural resources and materials
Extend lifespan of product and its parts	R3	Reuse	Reuse by another consumer of discarded product which is still in good condition and fulfils its original function
	R4	Repair	Repair and maintenance of defective product so it can be used with its original function
	R5	Refurbish	Restore an old product and bring it up to date
	R6	Remanufacture	Use parts of discarded product in a new product with the same function
	R7	Repurpose	Use discarded product or its parts in a new product with a different function
Useful application of materials	R8	Recycle	Process materials to obtain the same (high grade) or lower (low grade) quality
	R9	Recover	Incineration of material with energy recovery

And What Does This Mean for MedTech?

Circularity in MedTech is not the same as circularity in consumer electronics. We operate in a highly regulated industry, which makes implementing circular economy principles far more challenging. Today, much of healthcare still sits near the bottom of the value chain, with incineration remaining the default route for many products at the end of their life.

For most global players, the current focus is on Recycle and Recover (R8-R9), driven in part by new legislation such as the European Critical Raw Materials Act (CRMA), which encourages industries to recover high-value materials such as metals and rare earths from waste.

For start-ups, however, the picture is very different. You’re starting with a blank sheet of paper. You have the agility to embed circular thinking into your product from the outset, rather than trying to refit it later. That creates an opportunity to develop the kinds of innovations that larger companies will increasingly need as regulations evolve and customer expectations change.

In my next post, I’ll dig into why the 9R system is worth your attention as a founder; even if regulatory is already consuming most of your time.

In the meantime, take another look at the table above. Which of the 9R-strategies is closest to something you're doing, even if you've never described it in those terms?

References:

[1] Greene JA, Skolnik CL, Merritt MW. "How medicine becomes trash: disposability in health care." The Lancet, 2022;400(10362):1298–1299. DOI: 10.1016/S0140-6736(22)01941-9.

[2] "Health Care Plastic FAQs." Health Care Without Harm - Global, July 2024. https://global.noharm.org/focus/plastics/faqs.

[3] Potting, J., Hekkert, M., Worrell, E., & Hanemaaijer, A. (2017). Circular Economy: Measuring Innovation in the Product Chain (PBL Publication No. 2544). PBL Netherlands Environmental Assessment Agency, The Hague.

*** Regulatory Affairs and Circular Economy - explained in plain English.

What are your burning questions right now? Let me know... they may inspire my next post!