OBJECTIVES: To assess costs, utilities and cost-utility of fixed combination salmeterol/fluticasone (SAL/FP maintenance treatment) versus non-fixed combination budesonide + formoterol in one pack (BUD+FORM maintenance treatment) in the management of patients with bronchial asthma by means of an OPTIMA model. METHODS: In this analysis we used the following data: drug prices (from List of Maximum Permissible Manufacturer Prices for Vital and Essential Drugs) and drug dosage proportion (from MRC Pharmexpert, 4Q 2010); number of inhalations per day (from instructions); QOL and number of health care resources for controlled and uncontrolled asthma (from published sources); resource unit costs (from 2010 health care insurance program). Work-off day costs included tax deficiency, GDP underproduction and sick pay. Frequency of controlled asthma was obtained from ARROW study (Ogorodova et al., 2009) for SAL/FP (73%) and from FACET trial (O’Byrne et al. 2008) for BUD+FORM (62%). Conceptual formula of analysis was: cost of drugs + % controlled * cost of controlled + % uncontrolled * cost of uncontrolled. One-way sensitivity analysis was conducted to assess the robustness of the results. RESULTS: Average monthly costs of drugs were 1,677 RUR/€42 and 2,023 RUR/€51 for SAL/FP and BUD+FORM respectively. Medical costs and QOL measures were 378 RUR/€9 and 0.75 for controlled asthma; 88,295/€2,207 RUR and 0.49 for uncontrolled asthma. Yearly total costs per patient were higher for BUD+FORM than for SAL/FP (58,057/€1,451 RUR vs. 44,244 RUR/€1,106). Compared to BUD+FORM, SAL/FP was associated to an expected increase of QALYs per patient (0.68 QALYs vs. 0.65 QALYs). The cost-utility analysis showed that SAL/FP was dominant (less costly and more effective in terms of QALYs gained). Results were sensitive to all the parameters varied in the sensitivity analysis, especially health care costs. CONCLUSIONS: Treatment of patients with bronchial asthma with SAL/FP is a dominant strategy in comparison with non-fixed combination BUD+FORM in one pack.