Carbon footprint of severe asthma exacerbation management relative to Breezhaler® dry powder inhaler

Clinical Research Results Abstract IntroductionPatients with severe asthma exacerbations require systemic corticosteroids (SCS) and/or emergency room (ER) visits and/or hospitalisations, which contribute to carbon footprint (CFP). We report the estimate CFP of managing severe exacerbations as a basis for establishing net benefits of using low CFP inhalers such as Breezhaler® dry powder inhaler (DPI). MethodsCFP was estimated using Sustainable Care Pathways Guidance (www.sduhealth.org.uk) with outcomes for SCS use (≥3 days), ER visits and hospitalisations (Table). CFP of SCS (assumed to be in non-inhaler form) was derived from Carbon Trust’s ABPI tool. CFP range was cut off at a mean hospitalisation of 3 days; no CFP was estimated in the event of death. CFP associated with annual use of Breezhaler® DPI was reported elsewhere (Breezhaler® carbon footprint, www.novartis.com). ResultsCFP of managing severe exacerbation was 2.38–166.50 kgCO2e for seven management scenarios (Table). CFP of Breezhaler® DPI was reported as 6.13 gCO2e/dose (90-day pack, Germany). Thus, annual use of this inhaler by a patient (single dose/day) results in a CFP of ~2.24 kgCO2e. ConclusionsSevere asthma exacerbations may contribute a large CFP due to ambulance trips, ER visits andhospitalisations. Based on CFP estimates, the CO2 emission saving of avoiding a severe asthma exacerbation could be equivalent to the use of a low carbon DPI (Breezhaler®) for ~74 patient years. Research Idea Abstract Service Development & Evaluation Abstract Declaration of Interest Kai-Michael Beeh reports Honoraria or consultation fees from Novartis, AstraZeneca, Chiesi, Sterna GmbH, GlaxoSmithKline, and Berlin-Chemie.Funding: The study was sponsored by Novartis Pharma AG, Basel, Switzerland. References and Clinical Trial Registry Information