The upheaval caused by the Brexit situation was addressed by David Jefferys of Eisai Europe who spoke on “Regulatory Alignment between the United Kingdom and Europe Post Brexit,” and provided an overview of the effects of Brexit on pharmaceutical regulation. Jeffreys noted that with the delay until October 31, 2019, “uncertainty remains.” The regulatory system was “more integrated, more deep, than any other EU system,” and pharma is very different from other sectors, he explained, noting, “I don’t think any of us realized how complicated the supply chains are.”
In his talk on “Sustainable Respiratory Healthcare: Environmental Impact of Inhalers,” Alexander Wilkinson of the East and North Hertfordshire NHS Trust also emphasized the need for international cooperation. Climate change, he stressed, will make respiratory disease worse worldwide through increases in pollution, more ozone, and longer pollen seasons, with poorer nations bearing the brunt of the health consequences. “There’s an important issue of justice here,” he said.
Wilkinson discussed the potential impact of HFA 152a, a proposed MDI propellant that would have a lower carbon footprint, noting that 95-99% of an MDI’s carbon footprint comes from the propellant. Overall, he noted, only about 0.25% of the UK carbon footprint comes from inhalers. As for the NHS plans to reduce carbon footprint, about 4% of that planned reduction comes from switching away from MDIs to DPIs.
Wilkinson agreed that some reduction in MDI use is possible since 70% of the inhalers prescribed in the UK are MDIs — more than any other European country — but, he cautioned against assuming that patients should automatically be switched to DPIs, asserting that “some patients just need MDIs.” Hospital care is very carbon intensive, he pointed out, so switching patients to inhalers that don’t work for them is not very useful.
