Cost-effectiveness of as-needed budesonide-formoterol versus over-the-counter as-needed inhaled epinephrine in adults with mild asthma in the US

Inhaled epinephrine is the only current over-the-counter (OTC) option for the management of mild asthma in the United States (US). Given concerns of beta2-agonist overuse, and evidence-based guidelines recommending as-needed inhaled corticosteroid-formoterol as first-line reliever therapy, we examined the cost-effectiveness of OTC as-needed budesonide-formoterol compared to as-needed inhaled epinephrine and a no OTC inhaler option.