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Single maintenance and reliever therapy (SMART) with budesonide-formoterol was associated with lower overall annual asthma management costs compared with traditional maintenance therapy plus albuterol, according to a cost-effectiveness analysis in *JAMA Network Open*. Using midpoint federal supply pricing, total annual costs were $2,181 for SMART vs $2,235 for traditional therapy. Although inhaler costs were higher with SMART, reduced exacerbation-related morbidity costs offset these expenses. Across pricing models, 52% to 78% of simulations showed cost savings with SMART. Savings increased as budesonide-formoterol prices declined, highlighting the potential impact of generic availability. When quality-adjusted life-years (QALYs) were included, SMART produced a modest incremental gain (0.0006 QALYs annually) and a mean net monetary benefit of $118 per patient at a $100,000 willingness-to-pay threshold. The findings support broader insurance coverage of SMART as a clinically effective and economically favorable strategy for moderate to severe asthma, though longer-term analyses are needed.