OBJECTIVES: Utility based health outcome measures add more meaning to economic outcome analysis involving health related quality of life (HRQoL) assessments. The purpose of this study was to compare the cost effectiveness and utility analysis of inhaled corticosteroids like fluticasone, beclomethasone and budesonide at equipotent doses in asthma patients with patients’ perspective. METHODS: A prospective study was conducted on 187 asthmatics of GINA (Global Initiative on Asthma) grade-II, III and IV severity who received equipotent doses of either beclomethasone dipropionate (BDP), budesonide (BUD) or fluticasone (FP) for six months duration. As the cost analysis focused on patients’ perspective, the mean monthly cost on the Inhaled Corticosteroid (ICS) treatments were calculated based on both direct and indirect cost incurred. The percentage satisfaction was recorded on a 10cm Visual Analogue Scale (VAS) and QoL assessment performed using Saint Georges Respiratory Questionnaire (SGRQ). Treatment efficacy was compared using improvement in FEV1 (Forced Expiratory Volume in 1 second). Statistical analysis was performed using SPSS version-13.0. RESULTS: The overall QoL interpretation by VAS and SGRQ-total scores were checked for its association and found to be significantly correlating (r = -0.79, p<0.01). The mean cost per unit satisfaction (cost utility value) considering QoL improvement and the average cost effective ratio (ACER) were assessed for ICS treatments. Cost per unit satisfaction with ICS was comparable (p>0.05) between treatments, where BUD group showed value in Indian Rupees 7.92/-, FP-7.81/- and BDP-7.66/-. ACER with individual therapy also showed similar results between the ICS groups (BUD-0.93, FP-0.95, and BDP-1.06).   CONCLUSIONS: The study observed no significant difference between ICS groups with respect to cost utility value. At equipotent doses fluticasone, however, is similar to that of budesonide but more cost effective than beclomethasone dipropionate.