How AstraZeneca Has Created its First Sustainable Inhaler

Inhalers, particularly pressurised metered dose inhalers (pMDIs), account for 3% of the UK NHS’ total carbon emissions due to the propellants used in them.

AstraZeneca has received UK regulatory approval for the first inhaled respiratory medicine using a next-generation propellant with near-zero Global Warming Potential (GWP). 

This marks a world-first for pMDIs and a major milestone in reducing the environmental impact of respiratory treatments.

Sustainable propellants 

The approved treatment, Trixeo Aerosphere (budesonide/glycopyrronium/formoterol fumarate or BGF), is already a treatment for adults with chronic obstructive pulmonary disease (COPD) and is proven to be 200 times less damaging to the environment

This new inhaler is the first of AstraZeneca’s pMDI therapies to transition to HFO-1234ze(E) – a cutting-edge propellant that offers a 99.9% reduction in GWP compared to the current standard, HFA-134a.

With this change, Trixeo achieves a carbon footprint comparable to inhaled therapies that don’t use propellants at all. 

Marketed as Breztri Aerosphere in the US, China and Japan, the next-generation version of the medicine maintains identical dosage and clinical effect while significantly reducing its climate impact.

The approval by the UK Medicines and Healthcare Products Regulatory Agency (MHRA) follows a robust clinical development programme. 

Studies demonstrated bioequivalence between the new and existing formulations, confirming consistent safety and efficacy profiles. 

Regulatory reviews are also underway in Europe, China and other countries.

“Pressurised metered-dose inhaled medicines are essential for millions of people living with respiratory diseases in the UK,” explains Omar Usmani, Professor of Respiratory Medicine at Imperial College London.

“The transition of Trixeo to the propellant with near-zero Global Warming Potential means that healthcare professionals can focus on optimising outcomes for their COPD patients based on clinical need, while also supporting climate goals. 

“Clinicians and their patients shouldn’t feel that they have to choose between the most appropriate treatment and the planet.”

A climate-driven milestone for AstraZeneca

This approval will support AstraZeneca in its broader Ambition Zero Carbon strategy. 

By 2030, the company aims to convert its full pMDI portfolio to near-zero GWP propellants.

In the UK, the transition for Trixeo is set to begin in late 2025.

“The UK approval of Trixeo Aerosphere with the next-generation propellant is an industry first and a major milestone in AstraZeneca’s commitment to transition our pMDI portfolio to the propellant with near-zero Global Warming Potential,” comments Ruud Dobber, Executive Vice President, BioPharmaceuticals Business Unit, AstraZeneca.

“Starting with Trixeo, we are addressing the needs of both patients and the environment in devastating diseases like COPD, which affects hundreds of millions of people and is a leading cause of death globally.”

Inhalers using pMDIs account for 78% of global inhaler use and represent 0.04% of global GHGs. 

Improved disease control also plays a role in reducing environmental impact. 

Studies suggest the greatest carbon burden in respiratory care comes not from inhalers themselves, but from increased healthcare utilisation due to poor disease management. 

Optimised treatment, like Trixeo, can yield both clinical and sustainability benefits.

“The UK approval of Trixeo Aerosphere with the near-zero Global Warming Potential propellant marks a world ‘first’ and an important step in improving the environmental impact of our portfolio of inhaled respiratory medicines to support the NHS in achieving its net zero carbon goals,” explains Tom Keith-Roach, President of AstraZeneca UK.

“Trixeo with our next-generation propellant allows us to address the needs of both patients and the planet.”

Sustainable innovation in healthcare

The propellant HFO-1234ze(E) was developed by Honeywell and is considered crucial for transitioning pMDI medicines to low-emission formats. 

AstraZeneca has collaborated with Honeywell since 2022 to develop its respiratory medicines using this medical-grade compound.

This approval reaffirms AstraZeneca’s leadership in both respiratory care and sustainable pharmaceutical development. 

The company’s Ambition Zero Carbon strategy sets science-based targets, including a 98% reduction in Scope 1 and 2 emissions by 2026 and halving its Scope 3 footprint by 2030.

The company also aims to achieve carbon negativity for residual emissions by 2030.

As the first inhaled respiratory medicine to make this transition, Trixeo Aerosphere marks a critical turning point in reconciling high-quality patient care with pressing climate responsibilities — setting the tone for pharmaceutical sustainability across the industry.

Explore the latest edition of Sustainability Magazine and be part of the conversation at our global conference series, Sustainability LIVE. 

Discover all our upcoming events and secure your tickets today.

Sustainability Magazine is a BizClik brand