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Inhaler use and their carbon footprint in Germany: a 10-year analysis (2013-2022)
Sarah Blau1, Martin Mücke2, Michaela Hesse2
1Medical Faculty, RWTH Aachen University, Institute for Digitalization and General Medicine, Center for Rare Diseases Aachen (ZSEA), Aachen, Germany sarah.blau@rwth-aachen.de.
Inhaler carbon footprint increased due to stable use of high-emission pressurized metered-dose inhalers (pMDIs). Shifting to non-propellant inhalers (NPIs) could significantly cut greenhouse gas emissions.
Area of Science:
- Environmental science
- Public health
- Pharmacoeconomics
Background:
- Pressurized metered-dose inhalers (pMDIs) contribute significantly to healthcare's carbon footprint due to their greenhouse gas (GHG) propellants.
- Non-propellant inhalers (NPIs) offer a lower environmental impact compared to pMDIs.
- Reducing pMDI use is a key strategy for mitigating climate change within the healthcare sector.
Purpose of the Study:
- To analyze inhaler dispensing trends in Germany from 2013-2022.
- To estimate the carbon footprint (CF) associated with inhaler use.
- To quantify potential GHG savings achievable by increasing the use of NPIs.
Main Methods:
- Analysis of dispensing data from statutory health insurances in Germany (2013-2022).
- Calculation of annual dispensing shares and CF estimates for pMDIs (HFC-134a, HFC-227ea), DPIs, and SMIs.
- Development of two scenarios to project potential GHG savings based on increased NPI utilization.
Main Results:
- Inhaler dispensing increased by 14% (2013-2022) with no significant shift towards NPIs (52% NPIs in 2022).
- Total inhaler-related CF rose by 14% to 525 kt CO2eq in 2022, with pMDIs accounting for over 95% of the CF.
- A scenario with 85% NPI use projected a 55% annual CF reduction (288 kt CO2eq).
Conclusions:
- Inhaler-related CF has risen, driven by persistent pMDI usage, despite climate neutrality goals.
- A significant potential for GHG reduction exists through a transition to NPIs.
- Clinical practice changes promoting climate-friendly inhalers are necessary and feasible, with potential application in other European countries.
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