Inhaler and drug combination(s) studied (pack size) | Full life cycle appraised: • FF/VI 92/22 μg DPI (Relvar Ellipta; 30-day) • SAL/FP 50/500 μg Accuhaler DPI (Diskus; 30-day) • SAL/FP 25/250 μg pMDI (30-day) | Inhaler devices only, API not considered: • DPI (Diskus) (60-dose) • HFC-134a pMDI (100-dose/200 act) • HFC-227ea pMDI (60-dose/120 act) • HFC-152a pMDI (100-dose/200 act) | Full life cycle appraised • FORM/BDP NEXThaler 6/100 μg DPI (120-dose)# • FORM/BDP 6/100 μg pMDI (120-dose)# | Full life cycle appraised: • TIO Respimat SMI (disposable; 60 act per month) • IB/FEN Respimat SMI (120 act per month) • IB/FEN HFC pMDI (200 act per month) • IB HFC pMDI (200 act per month) | Full life cycle appraised: Easyhaler DPI: • BUD/FORM 160/4.5 µg (120-dose) • SAL/FP 50/250 µg (60-dose) • SALB 100 µg (200-dose) • FORM 12 µg (120-dose) | Full life cycle appraised: Breezhaler DPI: • IND/GLY/MF (30-day)+sensor • IND/GLY/MF (30-day) • IND/GLY/MF (90-day) • IND/MF (30-day)¶ |
Carbon footprint, kg CO2-eq per month | • FF/VI 92/22 μg DPI: 0.765 • SAL/FP 50/500 μg Accuhaler DPI (Diskus): 1.250 • SAL/FP 25/250 μg pMDI: 20.370 | • DPI (Diskus): 1.08+ • HFC-134a pMDI: 31.56+ • HFC-227ea pMDI: 83.64+ • HFC-152a pMDI: 2.4+ | • FORM/BDP NEXThaler 6/100 μg DPI: 0.916+ • FORM/BDP 6/100 μg pMDI: 11.33+ | • TIO Respimat SMI (disposable): 0.775 • IB/FEN Respimat SMI: 0.784 • IB/FEN HFC pMDI: 16.484 • IB HFC pMDI: 14.585 | Easyhaler DPI: • BUD/FORM 160/4.5 µg: 0.514 • SAL/FP 50/250 µg: 0.602 • SALB 100 µg: 0.664 for total life cycle§ • FORM 12 µg: 0.287ƒ | Breezhaler DPI: • IND/GLY/MF (30-day)+sensor: 0.481 • IND/GLY/MF (30-day): 0.359 • IND/GLY/MF (90-day): 0.184 |
Main contributor(s) to total carbon footprint | • FF/VI 92/22 μg DPI: manufacture of device and final product (90% of total carbon footprint (47% device manufacture, 43% manufacture of final product)) • SAL/FP 50/500 μg Accuhaler DPI (Diskus): API and device production (77% of total carbon footprint (48% API production, 29% device production)) • SAL/FP 25/250 μg pMDI: propellant (74% of total carbon footprint (56% during use, 18% at end-of-life disposal)) | • HFC-134a pMDI: propellant emissions during use (∼99% of total carbon footprint) • HFC-227ea pMDI: propellant emissions during use (∼80% of total carbon footprint) • HFC-152a pMDI: propellant emissions during use (∼80% of total carbon footprint) • DPI (Diskus): raw materials and device manufacture (∼90% of total carbon footprint) | • FORM/BDP NEXThaler 6/100 μg DPI: manufacture of device and packaging (57.9% of total carbon footprint (32.2% device packaging, 25.7% energy and water consumption during manufacture)) • FORM/BDP 6/100 μg pMDI: propellant (92.5% of total carbon footprint (70.2% during use, 22.3% at end-of-life disposal)) | • TIO Respimat SMI (disposable) and IB/FEN Respimat SMI: manufacture of device and cartridge (∼90% of total carbon footprint (∼60% device materials and production energy, ∼30% cartridge materials and production energy)) • IB/FEN HFC pMDI and IB HFC pMDI: propellant (∼98% of total carbon footprint) | • Easyhaler DPI##: device manufacture (54–65% of total carbon footprint) | • Breezhaler DPI##: manufacture of API, device and packaging; where sensor was included, the sensor raw materials were the main contributor |