This promotional content, which is intended for UK healthcare professionals only, has been developed and funded by Boehringer Ingelheim.

The UK has declared a climate emergency and is committed to ‘net zero’ carbon emissions by 20502

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Click here for prescribing information on SPIRIVA® RESPIMAT® (tiotropium) SPIOLTO® RESPIMAT® (tiotropium and olodaterol) and STRIVERDI® RESPIMAT® (olodaterol).

Sponsored byBoehringer Ingelheim

Asthma and chronic obstructive pulmonary disease (COPD) are the most common respiratory illnesses in the UK.3 With many asthma and COPD patients treated with inhalers,4,5 an estimated 75 million devices are used every year in this country.6 Pressurised metered-dose inhalers (pMDIs) account for 70% of this figure.1,7 The UK’s health services produce 5.4% of the country’s carbon emissions.8 Globally, healthcare’s climate footprint is equivalent to 4.4% of net emissions.8 Inhalers have a notable impact on the UK’s carbon footprint representing 3.5% of the NHS’s total greenhouse gas emissions.7

The NHS Long-Term Plan has set a target to deliver a 4% reduction in emissions including switching to lower carbon inhalers and reducing single-use plastics.9 NHS England and Public Health England are jointly funding the NHS Sustainable Development Unit to help meet these targets, which include moving to alternative low carbon inhalers and ensuring that currently essential plastics such as inhalers are disposed of safely.10,11,12 The Environmental Audit Committee has made switching to inhalers with lower global warming potential (GWP)* key to its strategy.7

Greener inhaler alternatives can make substantial financial savings while helping the environment1

Healthcare providers are critical in delivering environmental change, whether it is considering the carbon impact of inhaler purchases, to suggesting GPs switch to lower carbon alternatives, where clinically appropriate.13 Implementing these changes can provide substantial cost benefits; a recent study highlighted that for every 10% of metered-dose inhalers (MDIs) changed to the cheapest equivalent dry powder inhalers (DPIs), drug costs decreased by £8.2 million a year.1

It is vital that healthcare professionals with their patients choose the right inhaler for their needs, considering the patient’s ability to correctly handle and inhale from the device.14,15

Boehringer Ingelheim is committed to the sustainability goals of the NHS via product innovation and engagement with organisations driving change towards lower carbon healthcare solutions. For example, Respimat®, Boehringer Ingelheim’s propellant free soft-mist inhaler, has a carbon footprint approximately 20 times smaller than that of an ipratropium pMDI and was recently made reusable, with the potential to reduce this footprint by an additional 71%, when used with six cartridges.16,17,18,19

Healthcare leaders can play an important role in helping the NHS reduce its environmental impact and deliver on the sustainability goals of the Long-Term Plan, whilst making financial savings.

*Global Warming Potential (GWP) is a measure of how much energy the emissions of one ton of gas will absorb over a given period of time, relative to the emissions of one ton of carbon dioxide (CO2).20

Adverse events should be reported. Reporting forms and information can be found at Adverse events should also be reported to Boehringer Ingelheim Drug Safety on 0800 328 1627 (freephone).


1Wilkinson, AJK et al. 2019. Costs of switching to low global warming potential inhalers. An economic and carbon footprint analysis of NHS prescription data in England. BMJ Open, 9: e028763.

2UK Government. 2019. UK becomes first major economy to pass net zero emissions law. 27th June. Available at: Last accessed August 2020.

3British Lung Foundation. Chronic Obstructive Pulmonary Disease (COPD) Statistics. Available at: Last accessed August 2020.

4NHS Treatment – Asthma. Available at: Last accessed August 2020.

5NHS Treatment – COPD. Available at: Last accessed August 2020.

6Boehringer Ingelheim. IQVIA. February 2020 data.

7Environmental Audit Committee. 2018. House of Commons, UK progress on reducing F-gas emissions. Available at: Last accessed August 2020.

8Healthcare without harm. 2019. Health care’s climate footprint. Climate-smart health care series green paper number one. Available at: Last accessed August 2020.

9NHS. 2019. The NHS Long-Term Plan. Available at: Last accessed August 2020.

10NHS Sustainable Development Unit. Who we are. Available at: Last accessed August 2020.

11Public Health England. 2018. Reducing the use of natural resources in health and social care. 2018 report. Available at: Last accessed August 2020.

12Sustainable Development Unit. Anaesthetics and Inhalers. Available at: Last accessed August 2020.

13NHS. 2020. Update to the GP contract agreement 2020/21 - 2023/24. Available at: Last accessed August 2020.

14K.R Chapman. 2005. Inhaler choice in primary practice. European respiratory review. 2005 14: 117-122.

15Asthma UK. Sustainable inhaler switch must not be at the expense of people with asthma staying well. Available at: Last accessed August 2020.

16Spiriva Respimat. SmPC. Available at: Last accessed August 2020.

17Spiolto Respimat. SmPC. Available at: Last accessed August 2020.

18Striverdi Respimat. SmPC. Available at: Last accessed August 2020.

19Hänsel, M et al. 2019. Reduced environmental impact of the Reusable Respimat® Soft Mist™ Inhaler compared with Pressurised Metered-Dose Inhalers. Advances in therapy, 36(9), 2487–2492.

20United States Environmental Protection Agency. Understanding Global Warming Potentials – Greenhouse Gas (GHG) Emissions. Available at: Last accessed August 2020.

Job bag number: PC-GB-102268

Date of preparation: September 2020