Objective: Management of pediatric asthma is known to be very costly. However, little is known about the costs to the parent. We aimed to objectively assess employee and dependent costs for employees with children with asthma (EWCWA) compared with employees with children without asthma (EWCWOA). Methods: A retrospective analysis was conducted using multiple US-based employers' data from 2001 to 2007. Data included medical claims, pharmacy claims, payroll, work absence, and demographics. Asthma diagnosis (ICD-9 codes 493.xx) or pharmacy claims for an asthma controller medication were used to identify employees with asthmatic dependents aged <12 years for the EWCWA cohort. Employees in the EWCWOA cohort were identified based on dependent age and lack of an asthma diagnosis (ICD-9 code) or pharmacy claim for a controller medication. The index date in the EWCWA cohort was defined as the date of first asthma diagnosis during 2001 or later; the first pediatric medical or pharmacy claim date was used in the EWCWOA cohort. All costs were adjusted to 2007 dollars and incremental costs (EWCWA – EWCWOA) were calculated using two-part regression models and presented for health care and prescriptions. Regression models controlled for demographics, job information, Charlson Co-morbidity Index, and geographic region. Results: Data were available for the EWCWA (dependent age <4 yr: n=4577; 4-7 yr: n=4343; 8-11 yr: n=3954; total <12 yr: n=11,794) and EWCWOA (dependent age <4 yr: n=32,558; 4-7 yr: n=28,017; 8-11 yr: n=27,863; total <12 yr: n=64,812) cohorts. The incremental annual costs (EWCWA – EWCWOA) for employees and dependents (health care/prescriptions), respectively, were: dependent age <4 years: -$56/$73† and $663†/$568†; 4-7 years: $199*/$109† and $904†/$555†; 8-11 years: $364*/$116† and $1081†/$586†; <12 years: $154†/$95 and $862/$534 (*P<0.05, †P<0.01). Conclusion: Pediatric asthma results in significant additional costs for both employees and dependents.