The climate zealots are now coming for inhalers
Greenhouse Gas Emissions and Costs of Inhaler Devices in the US
Metered-dose inhalers prescribed for asthma and chronic obstructive pulmonary disease contain hydrofluorocarbon propellants, potent greenhouse gases that trap heat in the atmosphere thousands of times more powerfully than carbon dioxide. In England, these inhalers contribute an estimated 0.8 million metric tons (MMT) of annual carbon dioxide equivalent (CO2e) emissions,1 equivalent to 157 885 US homes’ yearly electricity use.2 In response, the National Health Service (NHS) has encouraged switching from propellant-containing metered-dose inhalers to propellant-free alternatives such as dry-powder and soft-mist inhalers.1
The US health care system produces 550 MMT of CO2e emissions annually3 vs 30.4 MMT of CO2e for NHS England,1 yet efforts to reduce inhaler-related emissions in the US have been hindered by limited data on the carbon footprint of US inhalers. We assessed mean emissions and costs and estimated total yearly emissions and costs for US brand-name inhalers prescribed to Medicare Part D and Medicaid beneficiaries. Medicare Part D and Medicaid account for approximately 40% of US retail prescription drug spending.4
Methods
All brand-name and generic inhaler prescriptions filled by Medicare Part D and Medicaid beneficiaries in 2022 were included. Emissions associated with the use and disposal of each metered-dose inhaler were calculated with the following formula: Weight of Inhaler Contents × Propellant Percentage × 100-Year Global Warming Potential of the Propellant. Inhaler weight was obtained from the package insert; the percentage and type of propellant were obtained from McKesson material safety data sheets; and the 100-year global warming potential, which represents the earth-warming effect of a gas relative to CO2 during 100 years, was obtained from the Sixth Assessment Report of the Intergovernmental Panel on Climate Change. Manufacturing and active pharmaceutical ingredient emissions for all inhalers were derived from prior European studies (eAppendix in Supplement 1).5,6 Mean emissions for each inhaler and by inhaler class (metered-dose, dry-powder, and soft-mist) were calculated. To estimate total emissions in 2022, mean emissions per class were multiplied by number of claims per class. Inhaler claims and costs were extracted from the Centers for Medicare & Medicaid Services (CMS) summary and statistics database. Analyses were performed with Microsoft Excel version 2308.
Results
Mean (SD) estimated emissions per inhaler by device class were 23.1 (11.3) kg of CO2e for metered-dose inhalers (n = 14), 0.79 (0.06) kg CO2e for dry-powder inhalers (n = 19), and 0.78 (0.0) kg CO2e for soft-mist inhalers (n = 4), where 10 kg CO2e equals 41.2 km driven in an average gasoline-powered passenger vehicle. The inhaled corticosteroid, long-acting β-agonist, metered-dose inhaler Dulera (mometasone/formoterol) had the highest emissions per inhaler, at 48.1 kg CO2e, and cost $444.37 per Medicare claim vs analogous inhaled corticosteroid, long-acting β-agonist, dry-powder inhaler Advair Diskus (fluticasone/salmeterol), which had 0.898 kg CO2e emissions per inhaler and cost $581.60 per Medicare claim. Among metered-dose inhalers, short-acting β-agonists were the most prescribed medication category, with 35.3 million claims. Within short-acting β-agonist medications, Ventolin HFA (albuterol sulfate) had the highest emissions, 28.7 kg CO2e per inhaler (Table).
In total, 69.8 million CMS inhaler claims in 2022 resulted in an estimated 1.15 MMT of CO2e emissions. Metered-dose inhalers accounted for 49.0 million claims (70.2%), 1.13 MMT CO2e emissions (98.3%), and $7.5 billion of spending (37.9%); dry-powder inhalers accounted for 17.1 million claims (24.5%), 0.014 MMT CO2e emissions (1.22%), and $10.0 billion of spending (50.8%); and soft-mist inhalers accounted for 3.6 million claims (5.2%), 0.003 MMT CO2e emissions (0.26%), and $2.2 billion of spending (11.3%) (Figure).
Discussion
Inhaler prescriptions filled by CMS beneficiaries in 2022 resulted in an estimated 1.15 MMT of CO2e emissions, equivalent to 226 960 homes’ yearly electricity use.2 Metered-dose inhalers were responsible for nearly all inhaler-related emissions, with the largest contribution arising from short-acting β-agonist medications. Although dry-powder and soft-mist inhalers had substantially lower emissions, they accounted for a disproportionate amount of spending, representing nearly two-thirds of inhaler costs but only one-third of claims.
Study limitations include that estimates of emissions were limited to the CMS-insured population and do not reflect national inhaler emissions. Manufacturing and active pharmaceutical ingredient emissions were extrapolated from European studies and carry some uncertainty. Claims prices may not represent patient out-of-pocket expenses.
This study highlights the magnitude of inhaler-related emissions in the US, as well as potential cost barriers to propellant-free inhaler substitutions. Formulary choices that optimize clinical efficacy, greenhouse gas emissions, and affordability may improve patient outcomes and reduce climate pollution.
https://jamanetwork.com/journals/jama/fullarticle/2822997
************************************************Tangled Comparisons: Renewables Versus Fossil Fuels
We are often told that wind and solar, if not cheaper, are at least cost competitive with fossil fuels. Dead wrong! Wind or solar costs around five times more per megawatt hour compared to, for example, natural gas.
We are told that wind and solar will save us from a climate catastrophe. If there is a looming climate catastrophe, the only thing that will save us is nuclear power. Wind and solar are incredibly expensive methods of reducing CO2 emissions. The more wind and solar you build, the cost of removing CO2 increases disproportionately.
The U.S. has wasted $1.5 trillion on wind and solar and for that money only a little more than 10% of our electricity comes from wind and solar.
Fossil fuels are not dirty. Modern natural gas or coal plants are environmentally pristine. CO2 is not a pollutant, but an aerial plant food that is greening the Earth. CO2 makes plants grow faster with less water.
Wind or solar electricity is not worth what it costs to create it. It is worth what someone is willing to pay for it. That is a generally accepted economic principle.
If the government requires a utility to purchase some amount of electricity at some price, that is not a free market. That is central planning. Central planning has a role, but it rarely works as well as the voluntary exchange of goods and services. Central planning creates unexpected twists and turns and often results in low productivity.
I will first discuss the value of wind and solar electricity in a free market and then discuss the effect of extensive government interventions via subsidies and mandates.
Everywhere when commentators compare the cost of wind or solar electricity with the cost of fossil fuel electricity, they use LCOE, the levelized cost of electricity. It is a logical error to compare LCOE of natural gas with LCOE of wind or solar. The correct comparison is to compare the marginal cost of natural gas with the LCOE of wind or solar. The marginal cost of natural gas electricity is about $20 per megawatt hour in the U.S. The LCOE of wind or solar hovers around $100 per megawatt hour, or about five times more.
LCOE includes amortization of the cost of building the generating plant. The marginal cost is essentially the cost of the fuel to generate the electricity.
Under what circumstances will a utility or grid operator be willing to purchase wind or solar electricity? For the sake of the discussion, we postulate that the utility is going to replace some of its natural gas electricity with wind or solar electricity. The argument would be the same if coal electricity is being replaced and different if hydroelectricity is being replaced. No one would replace nuclear electricity with wind or solar because nuclear fuel is too cheap.
The utility cannot make a complete replacement, scrapping a natural gas generating plant and replacing it with a wind or solar farm. That is impossible because wind and solar are erratic, providing power subject to the weather and the daily solar cycle. Their erratic nature cannot be fixed at a remotely reasonable cost with batteries or pumped storage.
The utility will be open to reducing output from a gas plant and replacing that electricity with wind or solar electricity, when the sun is shining or the wind is blowing, only If the wind or solar electricity is less expensive then the marginal cost of generating the electricity with the gas plant. Notice that I said marginal cost, not LCOE.
Marginal cost for a gas plant is almost entirely the cost of the fuel. If gas is $3 per MMBtu and the gas plant is a combined cycle plant, the marginal cost of generating electricity is about $20 per megawatt hour. In countries that do not enjoy cheap natural gas the marginal cost will be higher.
If the cost of the wind or solar electricity is greater than $20 it will be a money losing proposition to substitute wind or solar electricity for gas electricity. If it is less, then it will be a profitable endeavor. The value of wind or solar is $20 per megawatt hour under these conditions.
LCOE for a natural gas plant includes an allowance for the amortization of the initial investment. It also depends on the utilization or capacity factor of the plant. The capacity factor is not very relevant to the properties of natural gas generation because real utilities over-provision their generator capacity to account for peak demand and the possibility of plants being under repair.
LCOE for a wind or solar farm is almost entirely capital cost spread over the number of megawatt hours generated with due consideration for the time value of money. The marginal cost is near zero because it costs nothing extra to generate an additional megawatt hour and nothing is saved if fewer megawatt hours are generated. If plant output is curtailed because the grid cannot accept all the wind or solar power available, the cost per megawatt hour is proportionally increased. Overwhelming the grid with wind or solar is an increasingly serious problem.
The Departure From a Free Market
The most important government intervention is state renewable portfolio laws. These laws define renewable energy and set quotas for what proportion of the electricity in the state must be from renewable sources.
Without getting too complicated, renewable energy is usually defined as anything that is not fossil fuel, nuclear energy or hydroelectricity involving dams. Most of the energy that passes that test is too expensive or not scalable. Wind and solar are too expensive and handicapped by intermittency, but they are scalable. The result is that renewable energy is almost always wind or solar. A few states allow hydroelectricity with dams to be considered renewable. Hydro has limited scalability due to the best sites being already developed.
Renewable portfolio laws mandate the purchase of an increasing proportion of renewable electricity. For example, California requires that 60% of the electricity be from renewable sources by 2030.
The second most important government intervention are federal subsidies, tax credits and complicated tax provisions called tax equity financing, that subsidize about 50% of the cost of building a wind or solar farm.
Mandating the purchase of renewable electricity changes the nature of the market for renewable electricity. Without the mandates the owner of a wind or solar farm is doomed to beg utilities to purchase electricity for far less than it costs to generate. The farm would soon be bankrupt. But with mandates the utilities are knocking on his door begging for renewable power that they are mandated to purchase, without regard to the price. Renewable portfolio laws change the market from a buyers’ market to a sellers’ market.
There are a handful of companies with the expertise and financial resources to construct billion-dollar, utility-scale, wind or solar farms. Although they nominally compete by bidding for the sale of electricity, they constitute an oligopoly. That is to say that the competition will not be as vigorous as it would be if more players were in the market.
The most common deal structure is that the developer constructs a wind farm and sells the electricity to the utility. Because the market is tipped in favor of the big companies, they are able to require a long-term contract, called a power purchase agreement or PPA, usually 20 for years, guaranteeing a market at a set price for all the electricity that the project can produce. That long-term market and price guarantee has tremendous value.
The PPA is a subsidy because by removing market risk, the farm becomes less like a business and more like a treasury bond. The price per megawatt hour can be less because a lower rate of return is viable. Risk has been removed. With the guaranteed market, the farm becomes marketable to conservative investors like infrastructure funds or pension funds. I estimate that the PPA reduces the rate of return needed from 12% to 8% and thus subsidizes the cost of renewable electricity by a third.
That subsidy is not cost free. The utility is assuming massive debt and risk by signing the PPA. There are plenty of possible reasons why utilities might want to get out of PPA’s in five or ten years. For example, lower cost nuclear electricity.
Between renewable portfolio laws and federal subsidies, the wind or solar farm is about 66% subsidized. For example, if the LCOE of the wind or solar electricity is $100 per megawatt hour, after the subsidies are applied it is $33 per megawatt hour. This is still more than the $20 that the electricity is worth. To close the gap the utility must raise its rates to pay for the extra $13 per megawatt hour. The final subsidy comes from the electricity customers.
Justifications for Massive Subsidies
The first justification is that reducing CO2 emissions will prevent a climate catastrophe. This justification fails for several reasons. Reducing American CO2 emissions will have little effect because the emissions problem is in Asia where emissions not only dwarf ours but are skyrocketing due to development of coal powered generation.
The cost of reducing CO2 emissions by wind or solar is very high, more than $300 per metric ton of CO2 removed. The subsidy is the cost of removing CO2. It becomes increasingly difficult to augment the amount of wind or solar above 50% due to their intermittent nature. Carbon offsets can be purchased for as little as $10 per ton, although not enough would be available to neutralize CO2 emissions from the entire power system. Serious reduction of emissions at reasonable cost requires adopting nuclear power, generally prohibited by renewable portfolio laws.
The second justification is that fossil fuel or nuclear fuel will run out. Within the borders of the U.S. is enough fossil fuel for hundreds of years and nuclear fuel for thousands of years. It is not sensible to turn the economy upside down in anticipation of a theoretical event centuries in the future.
A third justification is that fossil fuel plants cause air pollution, and nuclear plants may release harmful radiation. Modern coal or natural gas plants are environmentally clean. Nuclear plants are proven by hundreds of plants running for decades. The worst accidents were easily contained.
Finally, the increase in CO2 in the atmosphere has greened the Earth and substantially increased agricultural production. CO2 is aerial plant food.
When will the nation wake up and stop the bleeding?
https://co2coalition.org/2024/08/22/tangled-comparisons-renewables-versus-fossil-fuels/
***************************************************Volvo abandons pledge to sell only electric cars. Not enough demand
The discipline of the markets is a wonderful thing
Volvo, the Swedish car marque renowned for its environmental commitment, has scrapped plans to sell only fully electric cars by 2030 in the latest sign of a global slowdown in growth for battery-powered vehicles.
Another of Europe’s leading carmakers, Germany’s Volkswagen, has indicated that it could shed thousands of jobs because of expected lower demand in a market disrupted by political and regulatory diktats on zero-emission vehicles.
Volvo, owned by Geely of China, has been in the vanguard of the electric revolution, stating as long ago as 2017 that by the middle of the current decade it would be building only all-electric or petrol-electric hybrids. In 2021 it went further, stating that it would be electric-only by 2030.
However, in a statement yesterday (Wednesday) it readjusted its commitments. It said that by 2030 it expected at least 90 per cent of its production to be either all-electric or plug-in hybrid. The remaining vehicles would be what it called “mild hybrids”, essentially petrol cars with energy-saving devices.
The decision, a U-turn by Volvo, was made by Jim Rowan, the Scot who is chief executive and who joined the company from the technology and consumer electronics industry in 2022. He was previously chief executive of Sir James Dyson’s consumer goods empire.
The Volvo emblem is seen on the front bumper of a vehicl in Austin, Texas. Volvo has cancelled plans to sell fully electric vehicles exclusively, stating that the company may need to hold onto its hybrid models as the transition to electric vehicles continues to develop.
The Volvo emblem is seen on the front bumper of a vehicl in Austin, Texas. Volvo has cancelled plans to sell fully electric vehicles exclusively, stating that the company may need to hold onto its hybrid models as the transition to electric vehicles continues to develop.
“We are resolute in our belief that our future is electric,” said Rowan, 59. “However, it is clear that the transition to electrification will not be linear and customers and markets are moving at different speeds of adoption.”
The latest jolts to the electric car revolution come amid growing consumer resistance to being forced into more expensive zero emission vehicles at a time of heightened inflation and interest rates and when public recharging networks are far from mature.
In Germany, the largest motoring market on the continent, electric car sales have plummeted since financial incentives were withdrawn. In Britain, the second largest zero emission vehicle market in Europe, electric car sales have stalled as a proportion of all new registrations.
The growing uncertainty about the take-up of electric vehicles was also behind the announcement from Volkswagen, Europe’s largest carmaker, that it will have to “resize” over the next couple of years in the face of falling consumer demand.
Volvo Group Australia President and CEO Martin Merrick says they took the “world's largest order” for Volvo medium duty electric trucks and by 2030 roughly “50 per cent” of the Volvo trucks they sell will be electric.
In meetings with worker representatives, Arno Antlitz, the finance director, said the outlook for VW, which had been increasing its drive into the electric car market, has changed and that the carmaker expects to produce far fewer vehicles than projected. “We are short of the sales of around 500,000 cars, the sales for around two plants,” said Antlitz from the company’s headquarters in Wolfsburg.
“That has nothing to do with our products or poor sales performance. The market is simply no longer there. We still have a year, maybe two, to turn things around. But we have to use this time. For some time now, we have been spending more money on the brand than we are earning. That doesn’t work in the long term.”
****************************************************
Royal Society understates cost of Net Zero by half a trillion pounds
A key report published under the auspices of the Royal Society understated the cost of building a Net Zero electricity grid by half a trillion pounds, according to Net Zero Watch, in a post published today on its website.
According to Net Zero Watch director Andrew Montford, the error revolves around how the costs of building wind and solar farms and other equipment will change over the next 25 years. The Royal Society has used Whitehall estimates of the costs for 2040 but has applied them from the start of the build period. Mr Montford said:
“It is simply absurd to use estimated costs for a windfarm in 2040 when calculating the costs of building one today.”
Mr Montford said
“If we assume that costs fall, over 25 years, from the levels seen today to those assumed by the Royal Society, the cost of building the Net Zero grid is around £960 billion rather than the £410 billion claimed by the Royal Society.”
Mr Montford says that there is no doubt about what the Royal Society has done, since the basis of the figure they have calculated is clearly stated in the report. However, although the Royal Society author team has been aware of the problem for several months, they have made no correction.
Mr Montford said:
“If the error is corrected, the cost of decarbonising the grid looks unaffordable. £960 billion is £38 billion per year, at a time when we are cutting winter fuel allowance to save less than £2 billion per year. Setting these painful facts out clearly would certainly be politically inconvenient for the Government.”
Notes
The Royal Society report, entitled Large-scale Electricity Storage was published last year.
Net Zero Watch published a critique, entitled Costing the Green Grid.
https://www.netzerowatch.com/all-papers/costing-the-green-grid
***************************************All my main blogs below:
http://jonjayray.com/covidwatch.html (COVID WATCH)
http://dissectleft.blogspot.com (DISSECTING LEFTISM)
http://edwatch.blogspot.com (EDUCATION WATCH)
http://pcwatch.blogspot.com (POLITICAL CORRECTNESS WATCH)
https://australian-politics.blogspot.com (AUSTRALIAN POLITICS)
http://snorphty.blogspot.com (TONGUE-TIED)
https://immigwatch.blogspot.com (IMMIGRATION WATCH)
http://jonjayray.com/select.html (SELECT POSTS)
http://jonjayray.com/short/short.html (Subject index to my blog posts)
***********************************************
Jim Hansen and his twin
No comments:
Post a Comment