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Background and Importance In recent years, the number of outpatient medications dispensed in hospital pharmacies has increased considerably. As tertiary hospitals serve large areas, many patients must travel long distances to collect their treatments, generating carbon dioxide (CO 2) emissions, with the consequent environmental impact. Delivering outpatient medications to patients’ nearest community pharmacies through cooperative distribution networks could promote the reduction of the carbon footprint.Aim and Objectives To evaluate the potential carbon footprint savings achieved by delivering outpatient medications from a hospital pharmacy to patients’ nearest community pharmacies through a cooperative distribution programme.Material and Methods This was a retrospective observational study that included outpatient medication deliveries between a tertiary hospital and community pharmacies that are part of a cooperative distribution programme according to the Official Association of Pharmacists of Barcelona (COFB). The study period ranged from March 2020, when the programme started, to mid-August 2025. Carbon footprints were assessed using the tool ‘Carbon Footprint Calculator’ 1 and expressed in tonnes of CO2 (tCO2). The potential carbon footprint savings were evaluated by quantifying the difference between patient travel from home to the hospital and back and the one-way deliveries to community pharmacies, as these deliveries followed the usual routes of wholesaler couriers. Data were obtained from the hospital clinical registry and the COFB online portal.Results A total of 26,136 medication deliveries from the hospital to community pharmacies were included: 976 in 2020, 3,013 in 2021, 4,705 in 2022, 6,219 in 2023, 6,738 in 2024, and 4,485 in the first 7.5 months of 2025. These deliveries resulted in progressively increasing annual carbon footprint savings ( figure 1), from 34.4 tCO2 in 2020 to 239.2 tCO2 in 2024, with 158.6 tCO2 achieved during the first 7.5 months of 2025 (projected to reach 253.8 tCO2 for the full year). The total savings over the study period were 918.5 tCO2.Abstract 4CPS-016 Figure 1Carbon footprint savings achieved by delivering outpatient medications to community pharmaciesConclusion and Relevance Delivering outpatient medications from a hospital pharmacy to patients’ nearest community pharmacies is associated with substantial carbon footprint savings and supports a more sustainable, environmentally friendly dispensing model.References and/or Acknowledgements 1. Carbon Footprint. Carbon Footprint Calculator. https://www.carbonfootprint.com/calculator.aspxConflict of Interest No conflict of interest