OBJECTIVES: To compare maintenance (using the fixed combination of Salmeterol + Fluticasone; SAL/FP) and symptomatic (no maintenance) treatments of asthma with a developed transparent pharmacoeconomic model. METHODS: Lack of asthma control leads to unscheduled resources utilization and so growth of total cost (direct and indirect). Algorithm of OPTIMA model calculation includes 4 steps: 1) Analysis of weighted average cost of maintenance medicines based on dosing, average prices in reimbursement, and dose distribution in assessing population, and 2) Assessment of cost associated with controlled and uncontrolled asthma based on number of unscheduled resources utilization (emergency service, outpatient visits, inpatient stay, and work-off days) and their unit-cost (sources - current Russian legislation, RosStat data) as well as QoL. 3) Detection of frequency of controlled/uncontrolled asthma in arms based on clinical trials data. 4) Calculation of total cost in arms (cost of drug + % controlled * cost of controlled + % uncontrolled * cost of uncontrolled) and amount of saving. RESULTS: Weighted average cost of SAL/FP in Russia was 1 672 Rub (~ 40 EUR) per month. Cost associated with controlled and uncontrolled asthma were 320 Rub and 62,753 Rub (~ €8 and €1,400) per patient per year, respectively; QoL scores were 0.75 and 0.49 respectiverly. Frequency of controlled asthma in SAL/FP arm was 75% (GOAL study) and so 25% patients were uncontrolled. Assumed frequency of controlled asthma using symptomatic treatment instead of SAL/FP = 5%. Total costs were 35 991 Rub and 59,632 Rub (~€850 and €,1400) in maintenance and symptomatic arms, respectively; average QoL score were 69% and 50.3%. CONCLUSIONS: The model allows transparent comparisons of different asthma treatment approaches. Maintenance treatment with SAL/FP was superior (less cost and higher QoL) to symptomatic treatment.