Objective: Despite the recommendations from national guidelines, under-use of controller medications and overuse of quick relief medications persists amongst asthmatics. The main objective of this study was to determine the effects of health insurance, prescription drug insurance and availability of peak flow meter on controller drug therapy not being used by asthmatic patients. Methods: Data for this study came from 2004 Medical Expenditure Panel Survey (MEPS).Study population included all asthma patients that reported occurrences of at least one asthma attack in twelve months. Multiple logistic regression was used to determine what factors are associated with the risk of absent controller drug therapy despite the frequent use of quick relief drugs, i.e., zero use of controllers in 12 months despite the use of 3 or more quick relief canisters in three months. Results: A total of 1164 patients reported at least one asthma attack in past 12 months. Among these patients, 434 (37%) reported no use of controller drugs despite the frequent use of quick relief canisters. The patients that did not have peak flow meter at home were more likely to report no use of controller drugs despite the frequent use of quick relief drugs (OR=1.93; 95% CI:1.92, 1.93). Health insurance (OR=1.44; 95% CI:1.43, 1.45) and prescription drug benefits (OR= 1.21; 95% CI:1.21, 1.21) also increased the risk of absent controller drug therapy. Conclusion: Having peak flow meter increased the likelihood of controller drug use indicating the usefulness of peak flow meter in asthma treatment and management. Health insurance and prescription drug benefit improved the likelihood of using controller drugs because of improved access. In order to improve the controller drug utilization amongst asthma patients, attention should be focused on patients lacking health insurance, prescription drug benefits and peak flow meters.