The Inter-Association Initiative on Pharmaceuticals in the Environment (IAI PIE) combines the expertise of the Association of the European Self-Medication Industry (AESGP), the European Federation of Pharmaceutical Industries and Associations (EFPIA), and the European Generic and Biosimilar medicines association (EGA), in order to address the emerging environmental concerns. This is being done through sound assessment of current and future actions, whilst remaining mindful of patient needs and ensuring access to medicines. Founded on the principles of product stewardship, the Eco-Pharmaco-Stewardship (EPS) initiative has been developed. It considers the entire life-cycle of the medicine and addresses the roles and responsibilities of all parties involved including public services, the pharmaceuticals industry, environmental experts, doctors, pharmacists, and patients.