OBJECTIVES: Inhaled corticosteroids can cause oropharyngeal adverse events (OAEs). We investigated the direct costs of treating oral candidiasis and hoarseness OAEs in Australia (costs $AUD). METHODS: We assumed 4% fewer OAEs in patients treated with ciclesonide (CIC), compared to fluticasone propionate (FP), based on data from a 12-week, randomized, double-blind clinical trial in patients with moderate asthma (comparable efficacy; OAE rate: CIC [400 µg/day] 0.5%; FP [500 µg/day] 4.5%; rate difference (RD) 4%, 95% CI: 1.04%-6.95%). Costings were done based on resource sparing and resource intensive assumptions. RESULTS: The resource sparing model assumed: 1.9 doctor visits ($30.85 per visit) and 1.9 nystatin treatments ($9.08 per treatment) to diagnose and treat OAE. The estimated treatment cost per OAE was $75.87. The average cost saving per patient treated with CIC per 12-week period was $3.03 ($75.87 x 4%). The cost saving per prescription with CIC per 12-week period was $2.02 ($3.03/1.5). Sensitivity analyses showed savings per prescription of $0.53 to $3.52 (using lower and upper 95% CI for OAE RD). The resource intensive model assumed: 3.4 doctor visits ($30.85 per visit) and 3.4 nystatin treatments ($9.08 per treatment) to diagnose and treat OAE; 1.0 specialist visit ($72.60) and 1.0 ketoconazole treatment ($38.58). The estimated treatment cost per OAE was $246.94. The average cost saving per patient treated with CIC per 12-week period was $9.88 ($246.94 x 4%). The cost saving per prescription with CIC per 12-week period was $6.59 ($9.88/1.50). Sensitivity analyses showed savings per prescription of $1.71 to $11.44 (using lower and upper 95% CI for OAE RD). CONCLUSIONS: We believe the improved safety profile of CIC would reduce resource use associated with treating OAEs and have favorable long-term clinical and economic outcomes.