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F-Gas Regulations and Beyond: Clinical and Economic Factors that will Drive Propellant Transition

Pritchard JN.

Respiratory Drug Delivery 2020. Volume 1, 2020: 183-194.


There are significant pressures to reduce the use of pressurized metered dose inhalers (pMDIs) because of the global warming potential (GWP) of the propellants they emit. However, there is a clinical need for these devices, particularly for reliever medications, because of their inspiratory effort independence and low cost. This paper shows that the top 10 markets would suffer an increase in costs if pMDI relievers were simply replaced by dry powder inhalers (DPIs). For other drug classes, the situation is less clear-cut, other than for triple combinations, which are also significantly cheaper in pMDI format. However, this outlook could change dramatically in 2025, when the phase-down in overall emissions of F-gases is likely to cause a three- to four-fold increase in the cost of goods of a pMDI. Thus, there is an urgent need for the pharmaceutical industry to develop affordable low-GWP alternatives; some companies have already started so others may be left behind.

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