Carbon dioxide equivalent emissions and cost impact of non-clinically driven inhaler initiation or switch for COPD.

CO₂e emission savings with non-clinically driven DPI use within the SITT class are offset by increased emissions from poorer clinical control and healthcare use. Prescribing policies/guidelines preferring DPIs over pMDIs for environmental reasons should be updated, recognizing that pMDIs with NGP have a greenhouse gas footprint similar to DPIs. Optimal COPD management through evidence-based guidelines and appropriate inhaler selection is crucial to minimizing carbon footprint and healthcare resource utilization while improving patient outcomes.