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April 2019

NICE encourages use of greener inhalers



A new NICE patient decision aid, released this month, aims to help people with asthma choose an inhaler that is better for the environment.

The guide points out that some inhalers have a much higher carbon footprint than others. While the priority is to select an inhaler that meets patients’ needs and controls their symptoms, where several inhalers could be viable options, patients can opt for the more environmentally friendly option.

NICE says this will help to cut the health service’s carbon footprint.

Metered dose inhalers (MDIs) contain hydrofluorocarbon (HFC) propellants, which are potent greenhouse gases. MDIs have an estimated carbon footprint of 500g CO2eq per dose, compared to just 20g in dry powder inhalers (DPIs).

More than 26m prescriptions for metered dose inhalers were written in primary care in England in 2016/17. They made up 70% of UK inhaler sales in 2011, compared with fewer than half in other European countries and just 10% in Sweden.

Professor Gillian Leng, deputy chief executive of NICE, said: ‘This aid will help people make shared decisions on which inhaler is right for them, and help them use that inhaler effectively. This can help them to control their asthma, rather than have their asthma control them.

‘People who need to use metered dose inhalers should absolutely continue to do so – but if you have the choice of a green option, do think about the environment. Cutting carbon emissions is good news for everyone, especially those with respiratory conditions.’

Funded by the Sustainable Development Unit, the decision aid also says that all used inhalers should be returned to pharmacies for recycling or environmentally safe disposal.