Objective: To gather information from managed care organization (MCO) decision makers and employers about asthma burden, evidentiary requirements, and product attributes that may influence formulary decision making for an emerging once-daily ICS asthma therapy. Methods: Telephone interviews were conducted among 10 MCO decision makers and 8 employers representing more than 51 million covered lives. Research focused on asthma burden, disease management strategies, and formulary decision making. Mean ratings on a scale from 1 (no effect; not at all important) to 10 (very large effect; very important). Results: Both MCOs and employers recognized the prevalence of asthma and challenges associated with management, including patient compliance with ICS. MCOs reported the economic impact of asthma was most notable in terms of hospitalizations (7.3), emergency department visits (7.2), and pharmaceutical costs (7.0). Employers identified burden of illness with employee absenteeism (6.0), presenteeism (5.3), workplace productivity (5.4), and employer health care costs stemming from both employee asthma and dependent children with asthma (5.3). ICS product efficacy, safety, compliance, and cost-effectiveness/value were the most important product attributes driving formulary decision making among MCOs. Both MCOs and employers had a favorable overall opinion of the product (6.9 and 6.8, respectively) and felt that compliance (8.4 and 8.9, respectively) would have a considerable impact on decision making. Majority of MCOs (7 of 10) reported once-daily dosing to be the most important product attribute (6.9). MCO interviewees emphasized that the product will need to be priced competitively to secure favorable positioning in a crowded ICS market. Post-launch evidentiary requirements may include the need for “real world” head-to-head comparative effectiveness studies. Conclusion: Efficacy, safety, compliance, and cost are primary factors driving formulary decision making when evaluating emerging ICS asthma therapies in a crowded market. MCO and employer organizations have similar priorities with respect to asthma management and formulary decision making.