Sustainability

Successful management of disease can reduce the carbon footprint of respiratory treatment

Patients with uncontrolled asthma typically have increased rescue medication use and often experience severe exacerbations, which may lead to emergency room (ER) visits, hospitalisations, and ambulance trips. All of these are associated with substantial greenhouse gas (GHG) emissions,^8,9 meaning that well-managed disease would lead to a reduction in the overall carbon footprint (CFP) a patient’s therapy.

To find out more about how reduced ER visits and rescue medication use may lead to lower carbon emissions, see the ATS 2021 poster presentation in section 5.⁸

To find out more about how severe asthma exacerbations may contribute a large carbon footprint as a result of ambulance trips, ER visits and hospitalisations, watch the ERS 2021 oral presentation in section 4.⁹

Pharmaceutical companies are committed to reducing their environmental impact

There are several global organisations (such as the World Health Organisation) and national healthcare organisations (such as the National Health Service in the UK) who are setting targets to reduce our global impact on the environment.

In addition to this, pharmaceutical companies are seeking ways to reduce the environmental impact of all aspects of their supply chain. The most recently published values indicate that pMDI manufacture and use accounts for 13% of total carbon emissions for AstraZeneca and 36% for GSK.^10,11 As such, a number of life cycle assessments (LCAs) have been carried out, which take into account all stages of inhaler development.

Novartis carried out an LCA for their BREEZHALER DPI and found that it has a low carbon footprint.¹² More information on the Novartis BREEZHALER LCA can be found in section 6. Data are published here:

Fulford B, Mezzi K, Whiting A, et al. Life-Cycle Assessment of the Breezhaler® Breath-Actuated Dry Powder Inhaler. Sustainability 2021;13(12):6657

References

Climate change: its impact on health and disease

Professor Rachel Huxley (Australia) outlines the social, economic and health impacts air pollution and global warming are already having. She highlights that ambient air pollution is worsened by climate change and also exacerbates asthma and may contribute to new onset asthma. There is therefore an imperative to reduce emissions in order to help reduce the associated health burden and population health threat due to climate change.

Our patients and our planet: considerations for inhaler choice

Professor Woodcock (UK) focusses the discussion on inhalers for respiratory conditions, highlighting the contribution of MDIs to the total carbon footprint of health care systems such as the UK National Health Service. He emphasizes areas in which the carbon footprint of inhalers could be lowered, including the use of DPIs where clinically relevant and acceptable to the patient.

Time to focus on green inhalers

View this poster presented at ATS 2021 to learn more about the carbon footprint of ER visits and rescue medication use in the IRIDIUM Phase III study. Results indicate that effective DPIs may reduce the need for rescue medication vs pMDIs, and therefore would also reduce the patient’s carbon footprint.

This comprehensive assessment of the Breezhaler^® dry powder inhaler (DPI) evaluated three variants of the DPI, assessing them across six key environmental impact categories, including: global warming potential, ozone depletion and resource use. The study was designed to identify major hotspots in the life cycle. View the slides to find out more about the environmental impact of the Breezhaler^® DPI.