OBJECTIVES Correct device technique has a significant influence on the delivery of inhaled therapies and can thus impact the control and management of asthma. The objective of this literature review was to examine the impact of device handling errors on QOL and healthcare resources to understand the potential value of a novel inhaler device for healthcare systems and patients. METHODS A literature search of articles published 2009–2013 was undertaken using MeSH terms and key words in MEDLINE®, supplemented by a grey literature review and searching of reference lists. Article selection and relevant data extraction were based on key words relating to handling error, QOL, and healthcare resource use. RESULTS Of 575 potentially relevant publications, 22 were selected for in-depth review. Papers reported 25–73% of patients make critical handling errors that lead to no-dose or reduced-dose delivery on first use of devices. Incorrect inhaler use was four times more frequently reported in patients with uncontrolled asthma than in patients with controlled asthma. Poor asthma control also impacts resource use: poorly-controlled patients made twice as many ER visits, and spent 2–3 times more time consulting with physicians than controlled patients (either physician visits or time speaking to physicians). Asthma control also impacts QOL: poorly-controlled patients reported health-state utility (EQ-5D) values of 0.52–0.69, compared to 0.88–0.93 for well-controlled patients. CONCLUSIONS Handling errors with devices can lead to poorly-controlled patients, resulting in reduced QOL and increased healthcare resource use. New inhaler devices represent an opportunity to reduce errors and improve asthma control, therefore improving QOL and reducing resource use. Further research is required to model the relationship between a reduction in handling error and improved asthma control status, and the subsequent impact on resource use and QOL.