TABLE 1.

Greenhouse gas (GHG) emissions related to short-acting β₂-agonist (SABAs) versus controller medication in 21 countries, and SABA overuse among patients with asthma from the seven SABA use in Asthma (SABINA) datasets and associated GHG emissions

	Per capita SABA use, doses per 10 000 persons per year	Per capita controller medication use, doses per 10 000 persons per year	*SABA versus* total inhaler use, %**	GHG emissions from SABA, tonnes CO₂e	GHG emissions from controller medication, tonnes CO₂e	*SABA versus* total inhaler GHG emissions, %**	Per capita GHG emissions from SABA, tonnes CO₂e per 10 000 persons per year	Per capita GHG emissions from controller medication, tonnes CO₂e per 10 000 persons per year	Total patients in SABINA database (GINA equivalent steps 1–2–3–5)	Volume of SABA prescriptions (GINA equivalent steps 1–2–3–5)	SABA prescriptions received by patients potentially overusing SABA reliever (GINA equivalent steps 1–2–3–5), %	Total GHG emissions from SABA overuse, tonnes CO₂e within this cohort	Per capita GHG emission from SABA overuse, tonnes CO₂e per 10 000 persons
Belgium	131 047	267 567	33	19 672	17 422	53	17	15
Bulgaria	125 630	141 248	47	11 959	6949	63	17	10
Canada^#	543 796	224 999	71	193 356	73 898	72	55	21
Alberta									107 444	274 175	81	4303	401
Nova Scotia									8034	34 677	94	694	864
Croatia	126 186	111 056	53	7253	4175	64	17	10
Czech Republic	125 088	210 556	37	17 563	18 485	49	17	17
Denmark	281 377	284 622	50	10 889	8017	58	19	14
Finland	278 298	337 388	45	10 963	11 563	49	20	21
France	383 001	229 696	63	334 716	126 131	73	50	19
Germany	275 899	234 476	54	293 638	144 077	67	36	18	13 030	39 643	74	540	415
Greece	237 510	288 218	45	34 223	20 988	62	32	19
Hungary	182 449	144 174	56	22 597	12 560	64	23	13
Ireland	743 424	300 928	71	48 986	16 782	75	98	34
Italy	125 516	144 659	46	104 503	86 040	55	17	14	22 102	17 866	69	240	108
The Netherlands	256 961	288 783	47	46 559	52 922	47	27	31
Norway	285 983	279 637	51	14 776	10 188	59	28	19
Poland^¶	98 770	166 863	37	49 893	43 738	53	13	11	98 876	135 424	74	1928	195
Romania	126 896	58 506	68	36 749	9371	80	17	4
Spain	318 751	222 311	59	195 771	86 977	69	40	18
Sweden⁺	238 512	349 211	41	11 632	12 895	47	12	13	365 324	794 589	69	2844	78
Switzerland	154 456	150 331	51	16 067	6174	72	20	8
UK	1 033 535	437 945	70	862 685	415 345	68	134	65	516 606	1 753 804	85	28 052	543

GHG emissions associated with medication use were quantified using SimaPro life cycle assessment software modelling resource and energy consumption data, in addition to Ecoinvent datasets and certified published studies. Per capita GHG emissions were calculated to allow comparisons across countries/datasets. CO₂e: carbon dioxide equivalent; GINA: Global Initiative for Asthma. ^#: data from Alberta and Nova Scotia from the SABINA datasets were analysed separately to compare SABA overuse and associated emissions across the two provinces; ^¶: patients with zero SABA use could not be categorised across GINA steps; ⁺: 8061 patients from Sweden could not be categorised according to GINA steps.