OBJECTIVES: Given the NHS's commitment to achieving net zero carbon by 2050, there's a push to assess and mitigate the environmental impact of inhalers. This study focuses on transitioning from metered dose inhalers (MDIs) to dry powder inhalers (DPIs) as a delivery method for salmeterol/fluticasone propionate (SAL/FP) in the United Kingdom (UK), aiming to evaluate both environmental and budgetary implications.

METHODS: Given the NHS's commitment to achieving net zero carbon by 2050, there's a push to assess and mitigate the environmental impact of inhalers. This study focuses on transitioning from metered dose inhalers (MDIs) to dry powder inhalers (DPIs) as a delivery method for salmeterol/fluticasone propionate (SAL/FP) in the United Kingdom (UK), aiming to evaluate both environmental and budgetary implications.

RESULTS: It was estimated that, where 18,141,411 prescriptions are expected to be utilised per year, transitioning SAL/FP from MDIs to DPIs would reduce carbon dioxide equivalent (CO₂e) emissions by 0.17 mega tonnes. However, this shift incurred an additional cost of £55 million to the healthcare budget, translating to £330.56/ton of CO₂e emissions saved. Scenario analyses indicated that the economic burden could be avoided by switching patients from MDI to the most cost-effective DPI alternative. This reduced CO₂e emissions by 0.16 mega tonnes and resulted in a £64 million saving. Regional disparities were observed across the UK, with Northern Ireland experiencing highest greenhouse gas (GHG) emissions savings.

CONCLUSIONS: The model highlights DPIs potential in reducing CO₂e emissions, but policymakers must carefully balance these benefits against fiscal implications. The analysis extends beyond markets relying on MDIs as the primary treatment option, encompassing broader implications. The methodological framework employed here can extend beyond, contributing to carbon savings and aiding in achieving targets across various disease areas