OBJECTIVES: Arformoterol tartrate inhalation solution (arformoterol) is a long-acting betaagonist indicated for long-term maintenance treatment of bronchoconstriction in patients with chronic obstructive pulmonary disease (COPD). Nebulized albuterol (albuterol) is a short acting beta-agonist indicated as rescue medication for acute COPD exacerbations, but often patients receive it in place of maintenance treatment. This analysis estimated total medical, pharmacy and rehospitalization costs for nebulized arformoterol compared with albuterol nebulized solution for the management of COPD in hospitalized patients. METHODS: An economic model was built comparing healthcare resource utilization and rehospitalization costs for arformoterol and albuterol from the hospital perspective. Pharmacy costs were calculated on a cost per hospital stay basis and were determined by the number of doses, frequency of administration, and hospital length of stay (LOS). Pharmacy costs were based on publically available wholesale acquisition costs. Medical costs included COPD exacerbation hospitalization costs, rehospitalization costs, and respiratory therapy costs. Cost of COPD-related inpatient hospitalizations were calculated as the cost per day times the mean LOS. Rehospitalization costs were calculated using rehospitalization rates at 30, 90, and 180 days. Respiratory therapy costs were based on the number of daily sessions for administration and the hourly rate of respiratory therapy. RESULTS: Mean LOS was 4.4 days for arformoterol vs. 5.2 days for albuterol. Arformoterol had lower rates of rehospitalization at 30, 90 and 180 days post-discharge, respectively (8.7% vs. 11.9%, 15.4% vs. 26.8% and 31.7% vs. 38.2%). Total medical and pharmacy costs per treated patient for arformoterol were $6,953 vs. $8,456 for albuterol, resulting in a savings of $1,503 per patient. Arformoterol yielded net savings of $338, $1,025, and $847 over albuterol in rehospitalization cost per treated patient at 30, 90 and 180 days, respectively. CONCLUSIONS: Total costs of arformoterol were less than albuterol nebulized solution due to lower hospitalization and rehospitalization costs.