ESG and Financial Performance in the Healthcare Industry: A Theory-Based Systematic Literature Review
DOI:
https://doi.org/10.55681/economina.v5i6.3030Keywords:
Corporate Sustainability, ESG, Financial Performance, Healthcare IndustryAbstract
This study aims to examine the theoretical mechanisms underlying the relationship between Environmental, Social, and Governance (ESG) and financial performance in the healthcare industry and to identify the dominant financial proxies and sustainability pillars discussed in the literature. The study employs a Systematic Literature Review (SLR) method following the PRISMA guidelines and combines content analysis with thematic analysis. The literature search was conducted in the Scopus database using keywords related to ESG, financial performance, and the healthcare sector. From an initial dataset of 60,929 records, 17 articles met the inclusion criteria for further analysis. The findings reveal that the ESG-financial performance relationship in the healthcare industry can be explained through five major thematic clusters: capital cost efficiency through transparency signaling, institutional compliance and social legitimacy, value dynamics in stakeholder management, ESG transformation into intangible assets, and cost trade-offs with supply chain coordination. The review also indicates that the financial impact of ESG is heterogeneous and influenced by industry context, market competition, and the characteristics of each ESG pillar. ESG practices may enhance investor confidence, legitimacy, and competitive advantage, but they may also impose initial costs that reduce short-term profitability.
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Agarwal, B., Gautam, R. S., Jain, P., Rastogi, S., Bhimavarapu, V. M., & Singh, S. (2023). Impact of Environmental, Social, and Governance Activities on the Financial Performance of Indian Health Care Sector Firms: Using Competition as a Moderator. Journal of Risk and Financial Management, 16(2). Scopus. https://doi.org/10.3390/jrfm16020109
Aspal, P. K., Singh, M., & Qazi, S. (2023). Impact of Paradigm Shift in Corporate Social Responsibility from Voluntary to Mandatory on Corporate Financial Performance. WSEAS Transactions on Business and Economics, 20, 2388–2399. Scopus. https://doi.org/10.37394/23207.2023.20.205
Atmeh, M., Shaban, M., & Alsharairi, M. (2020). Corporate Social Responsibility: Motives and Financial Performance. International Journal of Financial Studies, 8(4), 76. https://doi.org/10.3390/ijfs8040076
Calciolari, S., Cesarini, M., & Ruberti, M. (2024). Sustainability disclosure in the pharmaceutical and chemical industries: Results from bibliometric analysis and AI-based comparison of financial reports. Journal of Cleaner Production, 447. Scopus. https://doi.org/10.1016/j.jclepro.2024.141511
Candio, P. (2024). The influence of ESG score on financial performance: Evidence from the EUROPEAN health care industry. Strategic Change, 33(5), 417–427. https://doi.org/10.1002/jsc.2594
Chakraborty, J., Nagina, R., Paruthi, M., Saran, R., & Salam, F. (2026). Sustainability Disclosure and Firm Value: A Panel Analysis of Indian Pharmaceutical Companies. Journal of Applied Economic Sciences, 21(2), 495–513. Scopus. https://doi.org/10.57017/jaes.v21.2(92).06
Chen, Y., Mao, F., Liu, Z., & Wu, Y. (2026). Does corporate social responsibility of pharmaceutical manufacturing enterprises decrease debt financing costs? Economic implications through a moderated mediation model. Technological and Economic Development of Economy, 32(3), 963–995. https://doi.org/10.3846/tede.2026.25480
Ciasullo, M. V., Orciuoli, F., Douglas, A., & Palumbo, R. (2022). Putting Health 4.0 at the service of Society 5.0: Exploratory insights from a pilot study. Socio-Economic Planning Sciences, 80. Scopus. https://doi.org/10.1016/j.seps.2021.101163
Constantinescu, D. (2021). Sustainability disclosure and its impact on firm’s value for Energy and Healthcare industry. Central European Economic Journal, 8(55), 313–329. https://doi.org/10.2478/ceej-2021-0022
Creixans, J., & Arimany-Serrat, N. (2018). Influential variables in the profitability of hospital companies. Intangible Capital, 14(1), 171. https://doi.org/10.3926/ic.1109
Donkor, F., Papadopoulos, T., & Spiegler, V. (2021). The supply chain integration – Supply chain sustainability relationship in the UK and Ghana pharmaceutical industry: A stakeholder and contingency perspective. Transportation Research Part E: Logistics and Transportation Review, 155, 102477. https://doi.org/10.1016/j.tre.2021.102477
Donthu, N., Kumar, S., Mukherjee, D., Pandey, N., & Lim, W. M. (2021). How to conduct a bibliometric analysis: An overview and guidelines. Journal of Business Research, 133, 285–296. https://doi.org/10.1016/j.jbusres.2021.04.070
European Parliament & Council of the EU. (2022). DIRECTIVE (EU) 2022/2464 OF THE EUROPEAN PARLIAMENT AND OF THE COUNCIL of 14 December 2022. http://data.europa.eu/eli/dir/2022/2464/oj
Hermawan, S., Sari, Y. A., Biduri, S., Rahayu, D., & Rahayu, R. A. (2023). CORPORATE SOCIAL RESPONSIBILITY, FIRM VALUE, AND PROFITABILITY: EVIDENCE FROM PHARMACEUTICAL COMPANIES IN INDONESIA AND MALAYSIA. International Journal of Professional Business Review, 8(2). Scopus. https://doi.org/10.26668/businessreview/2023.v8i2.625
Hosseini-Motlagh, S.-M., Nami, N., & Farshadfar, Z. (2020). Collection disruption management and channel coordination in a socially concerned closed-loop supply chain: A game theory approach. Journal of Cleaner Production, 276. Scopus. https://doi.org/10.1016/j.jclepro.2020.124173
ISSB. (2023). IFRS - IFRS S1 General Requirements for Disclosure of Sustainability-related Financial Information. https://www.ifrs.org/issued-standards/ifrs-sustainability-standards-navigator/ifrs-s1-general-requirements/
Otoritas Jasa Keuangan. (2017). Peraturan OJK No. 51/POJK.03/2017 Tahun 2017 Tentang Penerapan Keuangan Berkelanjutan Bagi Lembaga Jasa Keuangan, Emiten, Dan Perusahaan Publik. Database Peraturan Perundang-Undangan Indonesia - [PERATURAN.GO.ID]. https://peraturan.go.id/id/peraturan-ojk-no-51-pojk-03-2017-tahun-2017
Paridhi., Ritika., & Kumar, R. (2024). ESG Practices and Financial Stability in Emerging Market Healthcare Companies: Insights Amidst the COVID ‐19 Pandemic. Thunderbird International Business Review, 66(5), 505–524. https://doi.org/10.1002/tie.22398
Pascuci, L. M., Meyer Júnior, V., & Crubellate, J. M. (2017). Strategic management in hospitals: Tensions between the managerial and institutional lens. BAR - Brazilian Administration Review, 14(2). Scopus. https://doi.org/10.1590/1807-7692bar2017160092
Qomariah, N., Nursaid, & Satoto, E. B. (2021). Improving financial performance and profits of pharmaceutical companies during a pandemic: Study on environmental performance, intellectual capital and social responsibility. Quality - Access to Success, 22(184), 154–165. Scopus. https://doi.org/10.47750/QAS/22.184.20
Ruberti, M., & Calciolari, S. (2025). Environmental Certifications as Strategic Assets? Evidence from Italian Chemical and Pharmaceutical Firms. Journal of Risk and Financial Management, 18(10), 562. https://doi.org/10.3390/jrfm18100562
Sinthupundaja, J., Chiadamrong, N., Kohda, Y., & Thajchayapong, S. (2020). Influence of intra and inter-organisational relationships on CSR and their impact on a hospital’s financial performance. International Journal of Business Governance and Ethics, 14(1), 78. https://doi.org/10.1504/IJBGE.2020.104703
Toumi, A. (2026). The impact of climate-related risks on firm performance: Evidence from the healthcare sector. Journal of Business and Socio-Economic Development, 6(2), 170–190. Scopus. https://doi.org/10.1108/JBSED-02-2025-0042
Yang, M., Wang, J., Maresova, P., & Akbar, M. (2022). Can the spending of corporate social responsibility be offset? Evidence from pharmaceutical industry. Economic Research-Ekonomska Istrazivanja, 35(1), 6279–6303. Scopus. https://doi.org/10.1080/1331677X.2022.2048194
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