P185 Life cycle assessment and cradle-to-grave carbon footprint of a multidose reservoir dry powder inhaler

Borenius, Kristian; Vartiainen, Ville; Takala, Aino K.; Haikarainen, Jussi; Parker, Grace; Paronen, Noora; Haahtela, Tari

doi:10.1136/thorax-2020-btsabstracts.330

Cited by 3 publications

(8 citation statements)

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“…There are clear differences in the carbon footprints of various inhalers [10,[26][27][28][29]31]. We have reviewed the published literature on the carbon footprint of inhalers and have identified a difference of up to 100-fold between lower-carbon DPIs/SMIs and HFC-134a pMDIs.…”

Section: Discussion/conclusionmentioning

confidence: 99%

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The environmental impact of inhaled therapy: making informed treatment choices

et al. 2021

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When selecting the best inhaler and drug combination for a patient with respiratory disease, a number of factors should be considered. While efficacy and safety of medical treatments are always a priority, in recent years the environmental impacts of all aspects of life have become an increasingly necessary consideration and inhaled therapies are no exception. The carbon footprint of an item, individual, or organisation, is one of the most important and quantifiable environmental impacts, assessed by the amount of greenhouse gases (often expressed in terms of CO2 equivalents) generated throughout the life cycle. The two most commonly prescribed and manufactured inhaler types worldwide are pressurised metered dose inhalers (pMDIs) containing hydrofluorocarbon (HFC) propellants and dry powder inhalers (DPIs). Most of the carbon footprint of current pMDIs is a result of the propellants that they contain (HFC-134a and HFC-227ea, which are potent greenhouse gases). In comparison, the powder in DPIs is dispersed by the patient's own inhalation, meaning DPIs do not contain a propellant and have a lower carbon footprint than most pMDIs currently available. Soft mist inhalers are another propellant-free option: the device contains a spring, which provides the energy to disperse the aqueous medication. In this review, we will examine the published data on carbon footprint data for inhalers, providing an analysis of potential implications for treatment decision making and industry initiatives.

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Section: Discussion/conclusionmentioning

confidence: 99%

“…Ltd. [29,30]. Table 2 shows the carbon emissions, per month, for the maintenance products included in this study [30].…”

Section: Studies Including Dpi Comparisonsmentioning

confidence: 99%

The environmental impact of inhaled therapy: making informed treatment choices

et al. 2021

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“…The Easyhaler DPI range has been certified carbon neutral using carbon offsets. [41][42][43][44][45][46] Re-fillable DPIs have the lowest carbon footprint.…”

Section: Studies Comparing Mdis and Dpismentioning

confidence: 99%

“…*Clenil HFA152a shows the predicted carbon footprint of a potential future HFA152a‐containing MDI. **Easyhaler devices in the UK are certified carbon neutral due to offsets applied to their carbon footprint 39–46 …”

Section: What Is the Carbon Footprint Of Inhalers?mentioning

confidence: 99%

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The environmental impact of inhalers for asthma: A green challenge and a golden opportunity

Wilkinson

Woodcock

2021

Brit J Clinical Pharma

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The propellants in metered‐dose inhalers (MDIs) are powerful greenhouse gases, which account for approximately 13% of the NHS's carbon footprint related to the delivery of care. Most MDI use is in salbutamol relievers in patients with poorly controlled disease. The UK lags behind Europe in this regard, with greater reliance on salbutamol MDI and correspondingly greater greenhouse gas emissions, roughly treble that of our European neighbours. There has been a broad switch towards MDIs in asthma treatment in the UK over the last 20 years to reduce financial costs, such that the treatment for two‐thirds of asthma patients in the UK is dominated by salbutamol MDI. Strategies that replace overuse of reliever MDIs with regimes emphasising inhaled corticosteroids have the potential to improve asthma control alongside significant reductions in greenhouse gas emissions. Real‐world evidence shows that once‐daily long‐acting combination dry‐powder inhalers (DPIs) can improve compliance and asthma control, and reduce the carbon footprint of care. Similarly, maintenance and reliever therapy (MART), which uses combination reliever and inhaled steroids in one device (usually a DPI), can simplify therapy, improve asthma control and reduce greenhouse gas emissions. Both treatment strategies are popular with patients, most of whom would be willing to change treatment to reduce their carbon footprint. By focussing on patients who are currently using high amounts of salbutamol MDI and prioritising inhaled steroids via DPIs, there are golden opportunities to make asthma care in the UK more effective, safer and greener.

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Reducing carbon footprint by switching to reusable soft-mist inhalers

et al. 2023

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ObjectiveInhalation therapy is the cornerstone of chronic obstructive pulmonary disease, together with non-pharmacological treatments. Long-acting muscarinic antagonists (LAMAs), alone or in combination with long-acting beta agonists (LABAs), are commonly used. Pressurised metered-dose inhalers (pMDIs), dry powder inhalers (DPIs), and soft mist inhalers (SMIs) are used, each with different carbon footprints. This study aimed to assess the carbon footprint of hypothetically replacing LAMA or LAMA/LABA inhalers with an SMI, Respimat Reusable, within the same therapeutic class.MethodsAn environmental impact model was established to assess the change in carbon footprint of replacing pMDIs/DPIs with Respimat Reusable within the same therapeutic class (LAMA or LAMA/LABA), across 12 European countries and the United States over 5 years. Inhaler use for country and disease-specific populations was derived from international prescribing data and the associated carbon footprint (CO2equivalents) were identified from published sources.ResultsOver 5 years and across all countries, replacing LAMA inhalers with Spiriva Respimat Reusable reduced CO2e emissions by 13.3–50.9%, saving 93–6228 tonnes of CO2e in the different countries studied. Replacing LAMA/LABA inhalers with Spiolto Respimat Reusable reduced CO2e emissions by 9.5–92.6%, saving 31–50 843 tonnes of CO2e. In scenario analyses, which included total replacement of DPIs/pMDIs, consistent CO2e savings were estimated. Sensitivity analyses showed that results were sensitive to changes in several parameters including varying assumptions around re-usability of inhalers and potential CO2e impact.ConclusionReplacement of pMDIs and DPIs with Respimat Reusable within the same therapeutic class, would result in substantial reductions in CO2e emissions.

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P185 Life cycle assessment and cradle-to-grave carbon footprint of a multidose reservoir dry powder inhaler

Cited by 3 publications

References 0 publications

The environmental impact of inhaled therapy: making informed treatment choices

The environmental impact of inhaled therapy: making informed treatment choices

The environmental impact of inhalers for asthma: A green challenge and a golden opportunity

Reducing carbon footprint by switching to reusable soft-mist inhalers

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