The study, “Inhaler-Related Greenhouse Gas Emissions in the U.S.,” quantified the climate footprint of 1.6 billion inhalers dispensed between 2014 and 2024. Researchers found that these products generated 24.9 million metric tons of CO₂ equivalent (CO₂e)—a total social cost of $5.7 billion and a 24% increase in annual emissions over the past decade.
“Inhalers are essential for treating asthma and COPD, but their propellants carry a climate burden that has been largely invisible,” said Dr. William B. Feldman, lead author and pulmonologist at UCLA, in the study.
Metered-dose inhalers, which use hydrofluoroalkane (HFA) propellants, accounted for 98% of all inhaler-related emissions. While hydrofluorocarbons replaced ozone-depleting chlorofluorocarbons in the 1990s, they remain potent greenhouse gases.
Three drugs—albuterol, budesonide-formoterol, and fluticasone propionate—were responsible for 87% of total emissions, with GSK, AstraZeneca, and Teva manufacturing the majority of products. The report found that brand-name inhalers produced 72% of emissions, suggesting that future reform efforts must include both patent-holding companies and generic manufacturers.
When scaled, the study’s findings equate to the annual electricity use of nearly 470,000 homes or the emissions from 530,000 gas-powered cars—a significant footprint for a single medical product category.
The U.S. federal government has committed to reducing hydrofluorocarbon use by 85% by 2036 under the Kigali Amendment to the Montreal Protocol, a phasedown already influencing refrigerants and industrial gases.
That same regulation now intersects with medical and pharmaceutical supply chains, linking hospital systems, insurers, and pharmacy benefit managers to the broader decarbonization agenda.
Policy experts argue that sustainable transitions in health care—mirroring those in HVAC and building sectors—will require coordinated procurement policies and investment in low–global warming potential propellants.
Globally, the U.K.’s National Health Service and the European Union have integrated inhaler emissions into net-zero frameworks, providing a model for how the U.S. might align future pharmaceutical standards with environmental regulations.
While inhalers represent less than 0.5% of total U.S. health care emissions, the study identifies them as a scalable test case for product-level climate accountability. The findings reinforce a wider call for ESG integration across health systems, where sustainable procurement, material innovation, and Scope 3 accounting are becoming standard practice.
Opportunities for progress include:
“This is about balancing patient safety, affordability, and environmental stewardship,” Dr. Feldman noted. “The technology to reduce these emissions already exists—the challenge is scaling it.”
For sustainability leaders in pharmaceuticals, manufacturing, and corporate ESG, this study highlights how product design and regulatory policy intersect in reducing emissions. Health care’s path to decarbonization parallels transitions in energy, transportation, and construction—where incremental innovation can yield exponential climate benefits.
As other sectors move toward net-zero, the health care industry’s emissions—long considered outside traditional energy discussions—are now squarely part of the sustainability equation.
