Inhalers and the Environment

The Impact of Inhalers on the Environment

The Montreal Protocol on Substances that Deplete the Ozone Layer was adopted in 1987 to help heal the Earth’s ozone layer.  The Montreal Protocol undertook to phase out chlorofluorocarbons (CFCs) and all other ozone-depleting substances.  Chlorofluorocarbons were used in a broad range of applications, including propellants in metered dose inhalers (MDIs) used to treat respiratory conditions (such as asthma and Chronic Obstructive Pulmonary Disease).  Chlorofluorocarbons are also potent greenhouse gases with high global warming potential (GWP).  The Montreal Protocol recognized the critical patient need for metered dose inhalers and the international community adopted a special “essential use” exemption to allow continued production of chlorofluorocarbons for metered dose inhalers while the industry undertook the lengthy, resource-intensive effort to research and develop chlorofluorocarbons-free alternatives that were safe and effective for patients.   IPAC’s publication, Ensuring Patient Care, provides additional background on the chlorofluorocarbons-metered-dose-inhaler, transition and the important work that was needed to develop alternatives. 

Hydrofluorocarbons (HFCs) emerged as the ozone-friendly medical propellant that met the important performance characteristics for a medical propellant, including safe for inhalation.  IPAC members invested substantial resources over two decades to accomplish the successful transition to chlorofluorocarbons-free alternatives, including dry powder inhalers (DPIs), soft mist inhalers (SMIs) and hydrofluorocarbon metered dose inhalers to meet the Montreal Protocol’s objective.  It was recognized that hydrofluorocarbons are greenhouse gases, but they have significantly lower global warming potential than chlorofluorocarbons so policymakers encouraged the transition as overall it contributed to both ozone layer healing and reducing greenhouse gas emissions.

The consortium recognises the environmental impact of certain devices but believes the environmental impact of propellants in inhaled therapies is a short-to-medium-term issue that will be addressed if innovation is adequately supported. As such, any steps to reduce the carbon and waste impact should be proportional and appropriate.
 
IPAC member companies, together with companies across the supply chain, are investing significant resources to innovate their products in order to meet the therapeutic needs of patients, while keeping the environmental impact and global warming potential of inhaled therapies front of mind.

Manufacturers of inhaled products continue to invest in new technologies, including next generation propellants, which will be near net “carbon zero.” 
IPAC is working with global organisations and international governments in order to improve the impact of inhaled devices on the environment.

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Patient Centricity

IPAC believes that significant environmental progress can be achieved while simultaneously improving patient health by focusing on a holistic, outcomes-based approach to treatment for respiratory patients. 
 
Well-managed treatment, appropriate prescribing, and device selection, together with ensuring the patient understands their own condition and can use their device effectively, can all potentially help improve patient outcomes through better control.

"optimising disease control is essential to minimising the environmental impact of respiratory healthcare."