OBJECTIVES: The National Health Service is estimated to produce ~4% of annual United Kingdom (UK) carbon emissions. There are several biologics in development for the treatment of Chronic Obstructive Pulmonary Disease (COPD), which accounts for 1 in 8 UK hospital admissions. The objective of this study is to estimate the impact of implementing a biologic therapy for COPD (using dupilumab as an exemplar) versus current standard of care on carbon emissions due to COPD treatment.

METHODS: Based on the sustainable healthcare coalition methodology, a lifecycle assessment approach was used to capture manufacturing, logistics, drug use phase including outcomes and post-use device disposal. The drug use phase was mapped across four defined areas for dupilumab versus standard of care. Healthcare resource utilisation for both pathways was modelled using linked Clinical Practice Research Datalink (Aurum) Hospital Episode Statistics (HES) data from Whitakker et al 2022, HES 2023 data and clinical data for dupilumab. Emissions were calculated using factors from Tennison et al 2021.

RESULTS: The implementation of a biologic for the treatment of COPD was estimated to result in total annual net carbon savings of 176-329 kg carbon dioxide equivalent (CO₂e) per patient, due to reductions in healthcare resource utilisation. Avoided hospitalisations alone had the most significant impact on carbon emissions, accounting for 246-369 kg CO₂e annual net carbon savings per patient. For the estimated total patient population, annual net carbon savings of 2.4-4.5 kt CO₂e were estimated. This is equivalent to ~5,500 return flights from London to New York.

CONCLUSIONS: The implementation of a biologic for the treatment of COPD may be carbon neutral or carbon saving through reductions in healthcare resource utilisation as a consequence of improved outcomes. However, this study is limited by the availability of specific data regarding emissions associated with the treatment pathways for COPD.