OBJECTIVES: National asthma treatment guidelines recommend the use of low dose ICS plus a LABA or moderate to high dose ICS as the preferred treatment for moderate asthma. The purpose of this study was to determine if physicians prescribe low/moderate dose fluticasone propionate/salmeterol (FSC) or moderate/high dose fluticasone propionate (FP) to subjects with similar asthma clinical profiles, medication use, and symptomology. METHODS: This was a retrospective observational study using medical, pharmacy, and enrollment information from a large, US managed care plan and linked medical chart data comparing 3 years of baseline characteristics and medication treatment patterns in adult asthma patients initiating FSC or FP. Data acquired from medical and pharmacy claims included provider specialty, baseline asthma medication resource use, occurrence of spirometry testing, and Deyo-Charlson co-morbidity score. A random sample of medical charts (n=460) was abstracted for baseline symptomology. RESULTS: A total of 32,189 subjects (average age: 46.6 [±14.4] years; 64% female) with an asthma diagnosis and initiating FSC or FP were identified from 1/1/06-12/31/07. Baseline co-morbidity scores were similar in FSC and FP patients (1.02 (1.31)) vs. 1.11 (1.50); p=0.488). A greater proportion of patients receiving FSC had a baseline spirometry compared to FP patients (32.6% vs. 20.4%; p=0.003) while. Shortness of breath was reported significantly more often for FSC (48.7% in FSC vs 38.3% in FP; p=0.024).  Other asthma symptoms were reported a similar rate across both groups and no significant differences in baseline use of other asthma medications were observed. CONCLUSIONS: Few significant differences in either claims history or asthma symptomology were observed between patients prescribed low/moderate dose FSC or moderate/high dose FP for the first time. Overall, physicians seem to be prescribing low/moderate dose FSC and moderate/high dose FP to similar asthma patients in alignment with national asthma treatment guidelines.