Stakeholders join forces to cut carbon footprint of asthma inhalers

Pharma News: A report launched by Ged Kearney, Assistant Minister for Health and Aged Care, aims to enhance the lives of individuals living with asthma while simultaneously reducing greenhouse gas emissions associated with respiratory inhalers.

Asthma Australia collaborated with Deakin University to facilitate a series of roundtables, engaging 50 organisations – including consumers, healthcare professionals, researchers, industry representatives, peak bodies, and government officials – to develop The National Sustainable Asthma Care Roadmap.

The funding for this initiative was secured through unrestricted grants from AstraZeneca, Chiesi Australia, GSK, and Orion Pharma Australia.

In December 2023, the government launched the nation’s first National Health and Climate Strategy, designed to enhance resilience against the health impacts of climate change and to curtail greenhouse gas emissions from the health system. This strategy incorporates an action plan to improve respiratory health outcomes and minimise emissions from respiratory inhalers.

Many asthma medicines are delivered through pressurised metered-dose inhalers (pMDIs), which use hydrofluorocarbon gases as propellants – substances that carry a significant carbon footprint. In contrast, dry powder inhalers (DPIs) can deliver the same amount of medicine effectively while reducing environmental impact.

AstraZeneca is accelerating the development of its next-generation respiratory inhalers using a propellant with near-zero Global Warming Potential (similar to that of dry powder inhalers), that is also non-persistent (breaks down easily in the environment) and non-bio accumulative (does not build up within living organisms). The first launches are anticipated in 2025.

GSK, on the other hand, is running trials of a low carbon version of its MDIs, containing a next generation propellant, which, if successful, could reduce its emissions by approximately 90%.

Asthma Australia’s Director of Health Knowledge and Translation, Anthony Flynn, stated, “The process of developing the Roadmap aimed to put people living with asthma at the centre of the conversation so that we are improving respiratory health as a primary goal while working towards environmentally friendly asthma care.

“This has been a sector-wide collaborative effort. We look forward to working with all those involved and the Australian and state and territory governments to progress the recommendations from the Roadmap and support the development of a national implementation plan.”

In Australia, around 25 million inhalers are sold annually, with approximately 80% being pMDIs. Evidence from the UK indicates that transitioning to DPIs, when clinically appropriate, could cut the environmental footprint of asthma care by as much as 95%.

The recommendations outlined in the Roadmap include launching a campaign aimed at educating individuals with asthma on improving their control of the condition – an effort that could also inherently reduce emissions.

The Roadmap further advocates for decreasing costs and enhancing access to combination anti-inflammatory plus reliever inhalers, which are more effective than reliever inhalers alone and are available in DPI form. It also emphasises the importance of increasing clinician knowledge and promoting best practices in both asthma care and sustainability.

Dr Mike Forrester, Senior Research Fellow at Deakin’s Institute for Health Transformation (IHT), added, “This is a great example of health and planetary co-benefits. Our report details the underlying system challenges, the evidence regarding the evolution of guidelines, the footprint of care, and the eight collaboratively developed goals to support the Roadmap, with key recommendations and actions for the sector.”

He further added, “Reducing the high rate of poorly controlled asthma and mitigating the environmental impact of pMDIs used to treat asthma represents a significant unmet need. Compelling evidence shows that transitioning to combination anti-inflammatory reliever asthma medication delivered using low-carbon devices can improve person-centred asthma outcomes while reducing greenhouse gas emissions.

“This Roadmap presents a compelling vision for the future of asthma care in Australia. We now hope to see investment and resources to translate these recommendations into a national implementation strategy.”

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