ASSESSING THE ENVIRONMENTAL BURDEN OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE IN SPAIN AND OPPORTUNITIES FOR EMISSION REDUCTION
Author(s)
Maria Reyes Abad, PharmD1, Carlos Almonacid, MD2, Maria del Mar Martínez-Vázquez, MD3, Mariano Pastor, EP4, Miguel Ángel Ponce, MD5, Alba Ancochea, MSc6, Isabel García, MSc6, Teresa Lastres, MSc6, Joaquín Sánchez-Covisa Hernández, MSc7, Miriam Prades, PhD8, Susana Aceituno Mata, MSc, PhD8.
1Pharmacy Department, Hospital Universitario Miguel Servet, Zaragoza, Spain, 2Pulmonology Department, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain, Madrid, Spain, 3Osakidetza, OSI Bilbao-Basurto, Centro de salud de Zorroza, Bilbao, Spain, 4Federación Nacional de Asociaciones de Enfermedades Respiratorias (FENAER), Madrid, Spain, 5Home Hospitalization Unit, Hospital Universitario de Gran Canaria Doctor Negrín, Las Palmas de Gran Canaria, Spain, 6Corporate Affairs and Market Access Department, AstraZeneca, Madrid, Spain, 7Medical and Regulatory Affairs Department, AstraZeneca, Madrid, Spain, 8Market Access Department, Antares Evidenze Health Consulting, Barcelona, Spain.
1Pharmacy Department, Hospital Universitario Miguel Servet, Zaragoza, Spain, 2Pulmonology Department, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain, Madrid, Spain, 3Osakidetza, OSI Bilbao-Basurto, Centro de salud de Zorroza, Bilbao, Spain, 4Federación Nacional de Asociaciones de Enfermedades Respiratorias (FENAER), Madrid, Spain, 5Home Hospitalization Unit, Hospital Universitario de Gran Canaria Doctor Negrín, Las Palmas de Gran Canaria, Spain, 6Corporate Affairs and Market Access Department, AstraZeneca, Madrid, Spain, 7Medical and Regulatory Affairs Department, AstraZeneca, Madrid, Spain, 8Market Access Department, Antares Evidenze Health Consulting, Barcelona, Spain.
OBJECTIVES: Climate change poses a major public health threat, particularly for diseases such as chronic obstructive pulmonary disease (COPD), highlighting the need for low-carbon healthcare systems that maintain care quality and safety. This study quantified the environmental impact of COPD in Spain and evaluated the potential reductions through sustainability-focused interventions.
METHODS: An Excel-based model was developed to estimate annual greenhouse gas (GHG) emissions in tonnes of CO2 equivalents (CO2e) from management of COPD. Epidemiological data defined the COPD population by diagnosis, disease control (proxied by absence of exacerbations) and severity. Emission factors were applied to convert activities into CO2e: visits and medical tests (energy consumption of facilities and devices), hospital stays (energy consumption, waste, laundry and diet), inhalers, and patient and caregiver transport (distance, mode and fuel type). Total emissions were estimated for the current scenario. Scenario analyses assessed the impact of actions aligned with Spanish Ministry of Health sustainable inhaler prescribing recommendations: (1) optimized diagnosis (4% increase) and enhanced disease control (69% controlled), (2) adoption of inhalers with a lower carbon footprint (including current and emerging technologies), (3) improved inhalation technique (83% controlled), and (4) increased inhaler recycling (5%) within existing systems. Data were collected from official sources and literature and validated by an expert panel. The analysis followed Sustainable Healthcare Coalition framework.
RESULTS: Total emissions in the current scenario were estimated at 617,370t of CO₂e/year. By emission source, transport accounted for 51%. By disease management, severe exacerbations accounted for 77%. Scenarios (1)-(4) could reduce emissions by 56,028, 31,105, 93,201, and 2,251t of CO₂e/year, respectively. Combining these interventions could reduce emissions by up to 26%.
CONCLUSIONS: COPD management in Spain imposes a substantial environmental burden. Interventions aligned with sustainability care recommendations offer a feasible pathway to reduce GHG emissions, combining healthcare with sustainability goals (Spain’s 2030 GHG reduction target: 45%).
METHODS: An Excel-based model was developed to estimate annual greenhouse gas (GHG) emissions in tonnes of CO2 equivalents (CO2e) from management of COPD. Epidemiological data defined the COPD population by diagnosis, disease control (proxied by absence of exacerbations) and severity. Emission factors were applied to convert activities into CO2e: visits and medical tests (energy consumption of facilities and devices), hospital stays (energy consumption, waste, laundry and diet), inhalers, and patient and caregiver transport (distance, mode and fuel type). Total emissions were estimated for the current scenario. Scenario analyses assessed the impact of actions aligned with Spanish Ministry of Health sustainable inhaler prescribing recommendations: (1) optimized diagnosis (4% increase) and enhanced disease control (69% controlled), (2) adoption of inhalers with a lower carbon footprint (including current and emerging technologies), (3) improved inhalation technique (83% controlled), and (4) increased inhaler recycling (5%) within existing systems. Data were collected from official sources and literature and validated by an expert panel. The analysis followed Sustainable Healthcare Coalition framework.
RESULTS: Total emissions in the current scenario were estimated at 617,370t of CO₂e/year. By emission source, transport accounted for 51%. By disease management, severe exacerbations accounted for 77%. Scenarios (1)-(4) could reduce emissions by 56,028, 31,105, 93,201, and 2,251t of CO₂e/year, respectively. Combining these interventions could reduce emissions by up to 26%.
CONCLUSIONS: COPD management in Spain imposes a substantial environmental burden. Interventions aligned with sustainability care recommendations offer a feasible pathway to reduce GHG emissions, combining healthcare with sustainability goals (Spain’s 2030 GHG reduction target: 45%).
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EPH93
Topic
Epidemiology & Public Health
Topic Subcategory
Public Health
Disease
Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory)