Impact of Choice of Inhalers for Asthma Care on Global Carbon Footprint and Societal Costs: A Long-Term Economic Evaluation
Author(s)
Kponee-Shovein K1, Marvel J2, Ishikawa R2, Choubey A3, Kaur H4, Ngom K1, Fakih I5, Swartz N1, Schatzki T1, Signorovitch J1
1Analysis Group, Inc., Boston, MA, USA, 2Novartis Pharma AG, Basel, Switzerland, 3Novartis Healthcare Private Limited, Hyderabad, India, 4Novartis Healthcare Private Limited, Hyderabad, AP, India, 5Analysis Group, Inc., Montreal, QC, Canada
OBJECTIVES : As guideline-recommended care for asthma increases globally, there is an opportunity to reduce asthma burden while minimizing greenhouse gas (GHG) emissions from inhalers. This analysis quantified the long-term global climate impact and economic impact of status quo asthma inhaler use compared to substituting metered-dose inhalers (MDIs), which use propellants with 1,300-3,350 times carbon dioxide’s (CO2’s) global warming potential, with propellant-free dry-powder inhalers (DPIs). METHODS : A 50-year time horizon (2020-2070) was evaluated and three scenarios were considered: A (status quo inhaler use), B and C (2% and 5% year-over-year substitution of MDIs with DPIs, respectively). Baseline global inhaler use and costs were sourced from IQVIA data, then projected using trends in per capita GDP, urbanization and asthma population growth from UN and WHO data. Spending on inhalers was assumed to fall by 90% following generic entry in 2030. Estimated inhaler CO2 equivalent (CO2e) emissions were derived from literature. Emission costs were based on the US government’s central and high-impact estimates for the social cost of carbon (SCC)1. RESULTS : Over 50 years, scenario A resulted in 823 million tonnes of CO2e emissions globally. The associated SCC was 21-65% of the projected global spending on asthma inhalers. Compared with scenario A, scenarios B and C reduced CO2e emissions by 38% and 58%, respectively. Depending on SCC estimates, Scenarios B and C increased global cumulative costs by 7.4% and 16.6%, respectively (central SCC), or decreased costs by 4.2% and 2.5% (high-impact SCC) versus Scenario A. CONCLUSIONS : Across SCC estimates, global substitutions of MDIs with DPIs at rates of 2% and 5% year-over-year can be either moderately cost-saving or cost increasing compared with the status quo over 50 years. Reductions in GHG emissions can be achieved through the substitution of MDIs with DPIs and warrant global policy attention. Reference:[1]US Government. Social Cost of Carbon, Methane, and Nitrous Oxide.2021
Conference/Value in Health Info
2021-11, ISPOR Europe 2021, Copenhagen, Denmark
Value in Health, Volume 24, Issue 12, S2 (December 2021)
Code
POSB94
Topic
Economic Evaluation
Topic Subcategory
Cost-comparison, Effectiveness, Utility, Benefit Analysis, Novel & Social Elements of Value
Disease
Respiratory-Related Disorders