Formulary optimization to reduce the carbon footprint of inhalers in a tertiary hospital

Abstract Objectives To reduce the carbon footprint of inhalers by formulary optimization. Methods The carbon footprint of inhalers dispensed in 2023 was audited. The preferred salbutamol metered dose inhaler was changed in March 2024. After 5 months, a second audit was done to assess this intervention. Key findings The carbon footprint was 109 tonnes of CO2 equivalents in 2023. Metered dose inhalers accounted for 97.8% of emissions (107 t CO2 equivalents) but only 55% (n = 4149) of inhalers dispensed. Following the intervention, monthly emissions were significantly lower (P = .048). Conclusions Inhaler formulary optimization significantly reduced the carbon footprint.