OBJECTIVE: to compare costs and effects of salmeterol/fluticasone propionate combination (SFC) 50/250µg bd with formoterol (12 µg bd) and budesonide (800 µg bd) (Form+Bud) given concurrently in adult patients with moderate-to-severe asthma. METHODS: The Markov model for the Polish Health care context was based on clinical data from the literature (data from randomised, double blind head-to-head comparison of SFC and Form+Bud treatments in adults) and local data on Health care resource utilisation and unit costs. Given their clinical and economic importance, asthma exacerbations were a central consideration in the development of the model. The outcome measure was number of successfully controlled weeks (SCW) during the study period. Only direct medical costs were analysed. The payer's perspective and time horizon of 12 weeks were adopted. Probabilistic sensitivity analysis was used to examine the uncertainty in the cost-effectiveness results. It was assumed that price of SFC is equal its components prices. RESULTS: Running the model over 12-week period using transition probabilities derived from RCT demonstrated that treatment with SFC in comparison to the treatment with Form+Bud resulted in a higher proportion of SCW per patient (2.68 [CI 95%: 2.29-3.13] vs. 2.44 [CI 95%: 2.05-2.85]). SFC was also the less costly treatment, due primarily to lower hospitalization and drug costs. Mean weekly direct asthma management costs was 58.39 PLN (CI 95%: 53.54 - 65.36) in SFC per treated patient and 72.42 PLN (CI 95%: 66.94-80.39) per Form+Bud treated patient. Probabilistic sensitivity analysis showed that in all cases SFC was the dominant strategy (more effective and less costly). CONCLUSION: Since SFC resulted in a better effect at a lower cost, this strategy was considered to be dominant for Polish patients with moderate-to-severe asthma.