Investing in a sustainable future for patients with respiratory disease

AstraZeneca announces commitment to launch its next-generation pressurised metered-dose inhaler (pMDI), containing a propellant with near-zero global warming potential (GWP), by 2025.

At the World Economic Forum (WEF) Annual Meeting we announced our commitment to launch a next-generation pressurised metered-dose inhaler (pMDI) to treat asthma and chronic obstructive pulmonary disease (COPD), containing a propellant with near-zero Global Warming Potential (GWP), by 2025.

This commitment is part of the ambitious programme, Ambition Zero Carbon, to eliminate carbon emissions from our operations (sites and vehicle fleet) across the world by 2025 and ensure our entire value chain is carbon negative by 2030, bringing forward decarbonisation plans by more than a decade. Climate change has emerged as a significant threat to public health, and it’s critical we urgently reduce our company’s environmental impact.

Most patients with asthma and COPD need inhaled medicines.1 pMDIs are one of the most common types of device used in inhaled medicine, and they currently contain small quantities of a type of greenhouse gas, which acts as the propellant to deliver the medicine into the lungs.2 They are an important device option for patients, particularly where familiarity with the device, limited lung function, young or advanced age, reduced dexterity or cognition are considerations.3,4,5,6


By offering both next-generation pMDIs, with near-zero GWP propellant, and DPI medicines, AstraZeneca is safeguarding important therapeutic options for patients while achieving ambitious environmental targets.

We expect the propellant used in our next-generation pMDI to have an environmental footprint, measured as GWP, that is 90-99% lower than propellants used in older pMDIs.7 Breztri Aerosphere (budesonide/glycopyrronium/formoterol fumarate), our triple-combination therapy for COPD, will be the first medicine to transition to this next-generation pMDI. AstraZeneca will also continue to offer dry powder inhaler (DPI) medicines.

By offering both next-generation pMDIs, with near-zero GWP propellant, and DPI medicines, AstraZeneca is safeguarding important therapeutic options for patients while achieving ambitious environmental targets.8 We believe it’s critical that reducing our impact on the environment does not compromise patient outcomes. AstraZeneca’s inhaled medicines reduce COPD exacerbations and asthma attacks, which are potentially life-threatening events.9,10,11,12

For example, even a single COPD exacerbation may be associated with a significant increase in the rate of lung function decline and can be associated with reduction in life expectancy.12,13,14 In asthma, there are an estimated 176 million asthma attacks each year globally with around 1,000 deaths each day.15,16  Well-managed, stable asthma and COPD patients also have a lower environmental impact than uncontrolled patients, who may over-use pMDI reliever therapies containing older propellants or require visits to healthcare services.8,17,18,19,20,21

We hope that this announcement serves as the basis for further collaboration amongst science companies, governments, regulators, healthcare systems and the respiratory community to reduce the environmental impact of medicines whilst also improving outcomes for those living with asthma and COPD.

Learn more about AstraZeneca’s wider efforts to promote environmental stewardship here.

Announcement in brief:

  • AstraZeneca has announced a commitment to launching its next-generation pMDI to treat asthma and COPD, containing a propellant with near-zero GWP, by 2025.
  • AstraZeneca expects the propellant used in the next-generation pMDI to have a GWP footprint that is 90-99% lower than propellants used in older pMDIs.
  • Our priority is to improve outcomes for patients with asthma and COPD. It is critical that the transition to our next-generation inhaler with less environmental impact does not compromise patient care. pMDIs are an important therapeutic option for patients and device switching without clear medical need can lead to life-threatening exacerbations and asthma attacks.22,23,24,25
  • The next-generation pMDI commitment supports further collaboration among science companies, governments, regulators, healthcare systems and the respiratory community to reduce the environmental impact of medicines while also improving outcomes for asthma and COPD.



  1. Usmani OS. Choosing the right inhaler for your asthma or COPD patient. Ther Clin Risk Manag. 2019;15:461–472.
  2. Myrdal PB, Sheth P, Stein SW. Advances in metered dose inhaler technology: formulation development. AAPS PharmSciTech. 2014;15(2):434–455. DOI:10.1208/s12249-013-0063-x.
  3. Lavorini F. The challenge of delivering therapeutic aerosols to asthma patients. ISRN Allergy. 2013;102418. DOI: 10.1155/2013/102418
  4. Usmani OS. Inhaler choice guideline. 2017. Choosing an appropriate inhaler device for the treatment of adults with asthma or COPD. Guidelines. Available at: [Last Accessed: January 2020].
  5. Roche N and Dekhuijzen PN. The evolution of pressurized metered-dose inhalers from early to modern devices. J Aerosol Med Pulm Drug Deliv. 2016;4:311–27. DOI:10.1089/jamp.2015.1232.
  6. Laube BL et al. What the pulmonary specialist should know about the new inhalation therapies. Eur Respir J. 2011;37:1308–1417. DOI: 10.1183/09031936.00166410.
  7. AstraZeneca. pMDI Sustainability: Lifecycle Assessment Results. May 2019. Internal.
  8. Usmani OS, Scullion J, Keeley D. Our planet or our patients – is the sky the limit for inhaler choice? Lancet Respir Med. 2019;7(1). DOI: 10.1016/S2213-2600(18)30497-1.
  9. Sastre J et al. Insights, attitudes, and perceptions about asthma and its treatment: a multinational survey of patients from Europe and Canada. World Allergy Organ J. 2016;9:13. DOI: 10.1186/s40413-016-0105-4.
  10. Beasley RW, Holliday M, Reddel HK et al. Controlled trial of budesonide-formoterol as needed for mild asthma. N Engl J Med. 2019; Epub ahead of print (DOI: 10.1056/NEJMoa1901963)
  11. Ferguson GT et al. Effect of budesonide/formoterol pressurized metered-dose inhaler on exacerbations versus formoterol in chronic obstructive pulmonary disease: the 6-month, randomized RISE (Revealing the Impact of Symbicort in reducing Exacerbations in COPD). Respir Med. 2017;132:31–41.
  12. Halpin DMG, Decramer M, Celli BR, et al. Effect of a single exacerbation on decline in lung function in COPD. Resir Med. 2017;128:85–91.
  13. Suissa S, Dell’Aniello S, Ernst P. Long-term natural history of chronic obstructive pulmonary disease: severe exacerbations and mortality. Thorax. 2012;67(11):957–63.
  14. Ho TW et al. HINT Study Group. In-hospital and one-year mortality and their predictors in patients hospitalized for first-ever chronic obstructive pulmonary disease exacerbations: a nationwide population-based study. PLoS One. 2014;9(12):e114866. DOI: 10.1371/journal.pone.0114866
  15. AstraZeneca Pharmaceuticals. Data on file. Budesonide/formoterol: Annual Rate of Exacerbations Globally (ID:SD-3010-ALL-0017).
  16. Global Asthma Network. The Global Asthma Report 2018. Available at: [Last Accessed: January 2020].
  17. Sustainable Development Unit. Care Pathways: Guidance on Appraising Sustainability. October 2015. Website. [Last accessed: January 2020).
  18. British Lung Foundation. Asthma statistics. Website. Available at: [Last Accessed: January 2020].
  19. Montreal Protocol On Substances that Deplete the Ozone Layer Report of the UNEP Medical and Chemicals Technical Options Committee, 2018 Assessment.  Available at: [Last Accessed: January 2020].
  20. O’Byrne PM, Jenkins C, Bateman ED. The paradoxes of asthma management: time for a new approach? Eur Respir J. 2017;50:pii:1701103.
  21. Exacerbation footprint is calculated as follows:
    Footprint from healthcare use is calculated assuming a typical hospitalisation of 3.33 ward days (validated by British Lung Foundation data). This includes NHS Sustainable Development Unit-guided carbon footprints of one-way emergency travel to hospital, a two-way journey of self-travel for a friend/family visit, self-travel home, two-way self-travel for a GP follow-up appointment, and the footprint of the GP appointment itself.  This has a larger carbon footprint than one of a half years of daily pMDI use, using MCTOC’s assessment of one dose per day of a typical HFA-134a pMDI.
  22. Doyle S et al. What happens to patients who have their asthma device switched without their consent? Prim Care Resp J. 2010;19(2):131–139. DOI: 10.4104/pcrj.2010.00009.
  23. Thomas M et al. Inhaled corticosteroids for asthma: impact of practice level device switching on asthma control. BMC Pulm Med. 2009;9:1. DOI: 10.1186/1471-2466-9-1.
  24. Jenkins D, Johal J, Mahon J. Analysis of the potential clinical impact of an environmentally driven transition from pressurised metered dose inhalers (pMDIs) to dry powder inhalers (DPIs). Thorax. 2019;74:A213–A214.
  25. Bjermer L. The importance of continuity in inhaler device choice for asthma and chronic obstructive pulmonary disease. Respiration. 2014; 8(4):346–52.


Veeva ID: Z4-22058

Date of preparation: January 2020

Date of expiry: January 2022



  • Sustainability