BACKGROUND: Effectiveness of internet-based self-management in patients with asthma has been shown, but its cost-effectiveness is unknown. We conducted a cost-effectiveness analysis of internet-based asthma self-management compared with usual care. METHODOLOGY AND PRINCIPAL FINDINGS: Cost-effectiveness analysis alongside a randomized controlled trial, with 12 months follow-up. Patients were aged 18 to 50 year and had physician diagnosed asthma. The internet-based self-management program involved weekly on-line monitoring of asthma control with self-treatment advice, remote web communications, and internet-based information. We determined quality adjusted life years (QALYs) as measured by the EuroQol-5D and costs for health care use and absenteeism. We performed a detailed cost price analysis for the primary intervention. QALYs did not statistically significantly differ between the internet group and usual care: difference 0.024 (95% CI -0.016 to 0.065). Costs of the internet-based intervention were $254 (95% CI $243 to $265) during the period of 1 year. From a societal perspective, the cost difference was $641 (95% CI $-1,957 to $3,240). From a health care perspective, the cost difference was $37 (95% CI $-874 to $950). At a willingness-to-pay of $50,000 per QALY, the probability that Internet-based self-management was cost-effective compared to usual care was 62% and 82% from a societal and health care perspective, respectively. CONCLUSIONS: Internet-based self-management of asthma can be as effective as current asthma care and costs are similar. TRIAL REGISTRATION: Current Controlled Trials ISRCTN79864465.

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