PharmacoEconomics & Outcomes News | 2019
Large drug cost and carbon savings by switch to DPI inhalers
Abstract
Switching to inhalers with lower global warming potential (GWP), such as dry powder inhalers (DPIs), can reduce drug costs and generate large carbon savings, say researchers from England. The researchers used 2017 prescription data from England obtained from the NHS Digital website to examine the economic and carbon impact of switching from metered-dose inhalers (MDIs), which contain propellants that are potent greenhouse gases, to lowGWP inhalers within each inhaler category (shortand long-acting beta-agonists, inhaled corticosteroids, shortand long-acting muscarinic antagonists, and combination devices). Different scenarios were modelled for switching to the cheapest equivalent DPI. Scenarios for replacing MDIs with DPIs according to current proportions of brand prescribing in England were also modelled. In scenarios where MDIs were replaced with the cheapest equivalent DPI, drug costs would decrease by £8.2 million annually for every 10% of MDIs changed to DPIs. In scenarios where MDIs were replaced with DPIs according to current proportions of brand prescribing, drug costs would increase by £12.7 million annually for every 10% of MDIs changed to DPIs. The MDIs assessed had a wide range of carbon footprints, 10–37 times that of a DPI. It was estimated that for every 10% of MDIs changed to low-GWP devices, 58kt CO2e could be saved annually in England. Patients, prescribers and guideline authors should carefully consider the carbon footprint of these inhalers and where they are likely to be equally effective, prioritise low GWP inhalers, suggest the researchers.