Question reference: S6W-07246
- Asked by: Monica Lennon, MSP for Central Scotland, Scottish Labour
- Date lodged: 14 March 2022
-
Current status: Answered by Humza Yousaf on 1 April 2022
Question
To ask the Scottish Government whether it will provide an update on what consideration it has given to the number of dry powder inhalers prescribed through the NHS, and what its position is on reports that (a) patients respond better to these inhalers and (b) the hydrofluorocarbon gases in the alternative aerosol spray inhalers are between 1,000 and 3,000 times more potent at warming the planet than carbon dioxide.
Answer
Dry powder inhalers(DPIs) make up 33% of the total in Scotland in primary care. In the last financial year (2020/2021), there were 4.5 million metered dose and 2.3 million dry powdered packs prescribed and dispensed via primary care and we have not seen a clear trend of those numbers changing and inverting.
Effectiveness of a powdered drug depends on a number of factors, including the inspiratory flow rate generated by the patient. For a significant proportion of patents, making the switch to a DPI will be successful, however, for some a DPI will not be suitable e.g. those with significantly impaired breathing. We would advocate regular medication reviews between the patient and GP at which time consideration should be given to switching to a DPI if deemed suitable for the individual patient’s circumstances
We recognise that hydrofluorocarbons used as propellant in metered dose inhalers prescribed for asthma and chronic obstructive pulmonary disease (COPD) can have a global warming potential of 1430 or 3220 times greater than CO2 depending on the type of gas used. Reducing the environmental impact of these inhalers is a priority.
A draft NHS Scotland Climate Emergency and Sustainability Strategy was published on 10 November 2021 and the consultation closed on 10 March 2022. This sets out the Scottish Government’s intention to publish an updated Scottish Quality Respiratory Prescribing guide which will focus on minimising patient over-use of inhalers through review and improving patient outcomes, using propellant free options where possible.
Other actions within the draft strategy include encouraging manufacturers to make inhalers with lower emissions and to support inhaler return to pharmacy schemes to help patients dispose of their used inhalers in a more environmentally friendly way.