We are changing so patients don’t have to
For millions of people living with asthma and chronic obstructive pulmonary disease (COPD), an inhaler is more than a medical device. It is part of a daily routine built on confidence, familiarity and trust that helps patients manage their condition and live their lives to the fullest.
The healthcare sector accounts for around 5% of global greenhouse gas emissions1. Within respiratory care, pressurized metered-dose inhalers (pMDIs) play a crucial role in patient care, but the propellants used in current pMDIs have a high global warming potential (GWP) and account for approximately 0.1% of global greenhouse gas emissions2.
As healthcare sector works to reduce its environmental impact, Chiesi believes progress towards sustainable respiratory care should support, not disrupt, the care patients rely on.
Since 2019, we have been developing the Carbon Minimal Inhaler (CMI) Program, a scientific, clinical and industrial initiative to transition to the next-generation propellant HFA 152a3.
This low-GWP propellant is expected to reduce the carbon footprint of our pMDI portfolio by up to 90% compared to Chiesi ones in use today and at the same level of dry powder inhalers (DPI)4, while supporting continuity of care for patients and healthcare professionals.
This transition is one of the most impactful actions in our Net Zero roadmap, as inhaler propellants are our single largest source of greenhouse gas emissions.
Climate change is a respiratory health challenge
Climate change is not only an environmental issue. Rising temperatures, air pollution and extreme weather can worsen symptoms and increase health risks for people living with respiratory conditions.
x6
For every 1°C rise in global temperature, respiratory patients face a mortality risk six times higher than the general population5.
88%
Of people with lung conditions reporting poor air quality said heatwaves and extreme weather worsened their symptoms6.
83%
Of people with lung conditions reporting poor air quality said going outside worsened their condition7.
At the same time, healthcare systems have their own environmental footprint. For Chiesi, reducing the impact of respiratory care while continuing to protect patient health is part of the same responsibility.
Why pMDIs need to evolve
pMDIs remain the preferred treatment option for many people living with asthma and COPD, including children, older adults and those with limited inspiratory capacity8.
Recognizing the need to reduce their environmental impact, Chiesi began investing in a new generation of pMDIs in 20199, before phase-down of high-GWP gases became mandatory for the the pMDI sector.
Our goal was not to replace pMDIs, but to evolve them.
Rather than asking patients to be switched to another product for non-clinical reasons or change the way they manage their condition, we set out to redesign what patients never see: the science inside the inhaler.
Good disease control can support environmental progress. Poorly controlled respiratory disease can increase use and reliance on rescue medication, contributing to greater environmental impact.
64%
more greenhouse gas emissions associated with poorly controlled symptoms, largely due to increased reliance on rescue medication10.
“Continuity of care and environmental progress are not competing priorities. For respiratory patients, they are the same priority.”
Maria Paola Chiesi - Chiesi Group Chair
The innovation behind a seamless transition
Changing the propellant is not a simple component swap and making the change has required years of scientific research, formulation development, clinical studies and regulatory validation.
The propellant in pMDIs influences how the medicine is formulated, delivered and deposited within the lungs. For this reason, we selected the next-generation HFA 152a propellant because it combines a significantly lower global warming potential with the characteristics needed to enable a seamless transition, helping people living with asthma or COPD continue to access the treatment and inhaler device that work best for them.
The CMI program is one of largest transformation initiatives ever undertaken by Chiesi, with more than €400 million invested in development since 201911.
Building the infrastructure for change
Scientific innovation is only part of the sustainable respiratory care transition.
Producing pMDIs using next-generation propellant at scale also requires new manufacturing capabilities, specialist engineering, and supply chain collaboration. We are pursuing this by expanding our French center of excellence in La Chaussée-Saint-Victor, redeveloping our newly acquired Nerviano site in Italy, which will be primarily dedicated to manufacturing carbon-minimal inhalers, and expanding our specialized manufacturing partnerships in the UK to secure resilient, industrial-scale global supply.
Carbon Minimal Inhalers at a glance:
Our Carbon Minimal Inhaler Program represents Chiesi's contribution to a broader transition in respiratory care, requiring coordinated action across the industry, including manufacturing partners, regulators and healthcare systems, to benefit both patients and environmental outcomes. For Chiesi, reducing the environmental impact of pMDIs is the single most important contribution we can make toward our Net Zero ambition, demonstrating that environmental progress and continuity of care do not have to compete, but can advance together.
Up to 90%
reduction in carbon footprint compared with current pMDIs
10x
Lower global warming potential compared to previous propellant gas12
Net Zero by 203513
70%
Use of Sold Products accounts for approximately 70% of our GHG footprint; CMI is a key step in our SBTi-validated journey to Net Zero14
Our CMI progress