The EAHP Board, elected for three-year terms, oversees the association’s activities. Comprising directors responsible for core functions, it meets regularly to implement strategic goals. Supported by EAHP staff, the Board controls finances, coordinates congress organization, and ensures compliance with statutes and codes of conduct.
Reducing hospital pharmacies’ carbon emissions by distributing fewer metered dose Inhalers
European Statement
Selection, Procurement and Distribution
Author(s)
Anna Harjans, Dominic Störzinger, Torsten Hoppe-Tichy
Why was it done?
Nowadays, norflurane is often used as MDIs’ propellant. It has a Global Warming Potential (GWP) 1,430 times higher than CO2. Therefore, MDIs cause larger emissions than DPIs. By lowering the numbers of MDIs in-house prescriptions, savings of emissions can be achieved.
What was done?
All Metered Dose Inhalers (MDI) of our formulary were screened for the following criteria:
– Which Active Pharmaceutical Ingredient(s) (API) are contained?
– Are comparable Direct Powder Inhalers (DPI) available?
– Can MDIs be replaced by a DPI considering wards and patients’ needs?
Distribution numbers one year before/after formulary adaptation were analysed. Furthermore, subsequent savings of greenhouse gas emissions have been calculated.
Note: Different devices cause different Carbon dioxide equivalent (CO2e) emissions because of their individual product life cycle, means that CO2e-calculations are depending on the manufacturer. Thus, it is imperative to name the exact devices in this analysis.
How was it done?
Availability of comparable DPIs with the same (combination of) API(s) and dosage for each MDI was assessed for the German market. Wards with highest orders of MDIs were identified to see who may be affected by a device change. Physicians in charge were contacted to replace MDIs where possible. Subsequently the formulary was adapted.
Saved emissions were calculated on the basis of current literature [Foster® 100/6 µg: 94.42 g CO2e/puff, Foster® NEXThaler® 100/6 µg: 7.63 g CO2e/puff (Pangione, S., et al. (2020))].
What has been achieved?
One MDI (Foster® 100/6 µg) was replaced in the formulary by an equivalent DPI (Foster® NEXThaler® 100/6 µg). Distribution numbers are shown below:
– Foster® 100/6 µg: 272 (one year pre adaptation), 4 (one year post adaptation)
– Foster® NEXThaler® 100/6 µg: 150 (one year post adaptation)
By means of this our hospital pharmacy reduced emissions by 2.921,9 kg CO2e compared to preadaptation.
What next?
MDIs containing new propellants with lower GWP are already being worked on by the pharmaceutical industry and thus, more climate friendly opposed to conventional MDIs. Replacing current MDIs with the novel, climate friendly alternatives once available on the market is a useful approach to further lower hospital pharmacies’ carbon emissions.