OBJECTIVES: With a prevalence of 10% asthma is the most common chronic disease among children and adolescents in Germany. Approaches to reduce the burden of asthma comprise patient education as a well-recognised and effective component that helps to improve self-management skills. We determined whether a continuous internet-based education programme (IEP) as an add-on to traditional education improves health outcomes of asthma patients (8-16 years) at a favourable benefit-cost ratio. METHODS: We performed a prospective cost-benefit analysis alongside a non-randomised trial. A total of 438 patients in 34 study centres in Germany were enrolled in the investigation. Study participants were assigned to a control group and two intervention groups. Patients in both intervention groups received traditional patient education. In one group patients received additional self-management education through the IEP for the duration of 6 months. At the initial visit and at 6 and 12 months health service utilisation data were collected. RESULTS: Utilisation of various Health care services (e.g. number of consultations, urgent medical examinations) decreased significantly in both intervention groups. In the first year after intervention traditional education realised morbidity cost savings of 333 EUR per patient. Adding the IEP provided incremental savings of €143. From a payer perspective, the benefit-cost ratio of the traditional education programme was 0.45. Adding the IEP improved the ratio (0.69). For patients with moderate or severe asthma the benefit-cost ratio were 1.07 and 1.42 (with IEP). In individuals who had experienced an emergency visit due to asthma 6 months prior to the study entry, the ratios were 1.11 and 1.21, respectively. CONCLUSIONS: As a supplementary to traditional asthma education programmes, the IEP offers the potential to realise incremental morbidity savings. Subgroup analyses demonstrated that within 1-year morbidity cost savings surpass the intervention costs in patients who belong to risk groups.