OBJECTIVES: To evaluate the long-term cost-effectiveness of RMTAC (an adjunct pharmaceutical asthma management) vs. usual physician care clinic by using decision analytic modelling method. METHODS: A dynamic adherence asthma Markov cohort model was developed. The economic evaluation was based on a lifetime horizon and cycle length of one month, from the healthcare provider‘s (Ministry of Health) perspective, with the outcomes assessed in cost per QALY gained and cost per hospitalization averted.  Probabilities of asthma control-adherence states from RMTAC database, costs from national sources, utilities using standard gamble method on Malaysia’s asthma patients, and other inputs from secondary data sources were used to inform the probabilistic model, according to gender and age subgroups. A scenario analysis was conducted to test the structural assumption on follow-up visits after the final treatment visit. RESULTS: In female subgroup, RMTAC management dominates the usual care by having 0.91 (95% CI 0.24 – 1.69) QALY gained and 0.58 (95% CI -2.30 – 6.23) hospitalization averted, at a lower cost. For male subgroup, the ICERs were RM10 (95% CI -RM14431 – RM8323) per QALY gained and RM18 (95% CI -RM35790 – RM30266) per hospitalization averted. At the willingness-to-pay threshold of RM29000 per an additional QALY gained, the RMTAC intervention is likely to be cost-effective 99% and 57% of the time (for QALY and hospitalization outcome, respectively). The analysis was robust to assumptions of follow-up visits frequency and patients’ gender. CONCLUSIONS: Implementing RMTAC in Malaysia has high probability of being more cost-effective than the usual care management for both male and female subgroups across all age groups. Further investigation is necessary to ensure that implementing this decision does not exceed the overall national healthcare expenditure.