Life-Cycle Assessment of the Breezhaler® Breath-Actuated Dry Powder Inhaler

Abstract

The Breezhaler® dry powder inhaler (DPI) has a low carbon footprint compared with other inhalation therapies, consistent with the literature on other DPIs. This life-cycle assessment was conducted in France, Germany, the UK, and Japan using a “cradle-to-grave” technique to evaluate six environmental impact categories (global warming potential; acidification; ozone depletion; use of resource, minerals, and metals; eco-toxicity; and freshwater use) associated with the use of the Breezhaler®. Three variants of the Breezhaler® (30-day packs with and without the digital companion and a 90-day pack without the digital companion) were evaluated to identify major hotspots in the device life-cycle and to provide realistic solutions to reduce the environmental impact. Although no single life-cycle stage dominated the climate change impact of the 30-day device with the digital companion, the inhaler’s raw materials and packaging contributed to 96% of the resource depletion impact for the 30-day device without the digital companion. For the 90-day device without the digital companion, packaging contributed 42–62% of the impact across all categories. Overall, the Breezhaler® inhaler with the 90-day pack had the lowest environmental impact. The environmental impact of the device did not vary significantly among the considered markets. Further studies are needed to assess the impact of active pharmaceutical ingredients and improvement in clinical outcomes on the environment.

Carbon Footprints and Life Cycle Assessments of Inhalers: A Review of Published Evidence

“…Figure 3 presents the results of the Jeswani and Azapagic [15] and Fulford et al [16] studies, normalized with respect to person equivalents, published by the National Institute for Public Health and the Environment Ministry of Health, Welfare and Sport in the Netherlands for the ReCiPe impact assessment method used in these LCAs. A person equivalent is a quantification of the environmental impact caused annually by the activities of an average citizen.…”

“…Figure 1 is a graphic representation of the breakdown of the footprint by life cycle stage, where this granularity is available at the source. To examine whether other DPIs present similar impacts, and to examine the effect of the design on these, Fulford et al conducted an LCA of the Breezhaler ® device alone, excluding API [16]. Figure 2 The use and end-of-life stages together contribute to most of the CFP of the MDI inhalers, typically in excess of 85%.…”

“…To examine whether other DPIs present similar impacts, and to examine the effect of the design on these, Fulford et al, conducted an LCA of the Breezhaler ® device alone, excluding API [16]. Figure 2 presents the impact results for all inhalers studied by Jeswani and Azapagic and the results from the LCA study by Fulford et al, for Breezhaler ® only in the German market, using a scale in which the impact of each device is presented as a percentage of that with the highest impact [15,16]. The generic DPI has the highest reported impacts for 6 of the environmental impact categories reported, whereas Breezhaler ® has the highest impact for 4 impact categories.…”

The environmental impact of inhaled therapy: making informed treatment choices

“…The use of rescue salbutamol pMDIs in Italy, Spain, France, Germany and the UK is estimated to produce 1,791,312 tonnes CO2 eq per year, of which 250,000 tonnes is a result of SABA overuse (prescription of ≥3 canisters per year versus 0-2) in the UK alone [46]. A new trend for the addition of inspiratory sensors will result in a small increase in carbon footprint [31,37], but this could be offset by improved patient adherence in the real world [47] and resulting reductions in rescue medication use.…”

“…metal depletion and terrestrial acidification) [10]. However, we anticipate that the use of newer, refillable DPIs will decrease this effect, due to decreased raw material depletion [10,37]. Complete data on one such device, the Breezhaler ® DPI, has recently been released, showing the relative contributions of each lifecycle stage to six environmental impact categories (global warming potential; acidification; ozone depletion; use of resource, minerals, and metals; eco-toxicity; and freshwater use) [37].…”