What is SMART?
- SMART, which stands for Single Maintenance and Reliever Therapy (SMART), is the guideline-recommended inhaler therapy for moderate-to-severe persistent asthma.
- SMART uses a single metered dose inhaler (MDI) combining an inhaled corticosteroid (ICS) and a long-acting beta agonist (LABA) that patients use on both a daily and as-needed basis. In SMART, patients can use the same inhaler every day and as needed.
The ICS (budesonide or mometasone) component reduces inflammation. It reduces asthma symptoms and decreases the risk of sudden asthma exacerbations or flares.
The LABA component (formoterol) quickly relieves asthma symptoms by relaxing the muscles around the airways. Formoterol is the only LABA usable with SMART due to its quick action.
Why SMART?
- SMART is the recommended treatment for moderate-to-severe persistent asthma in adolescents and adults.
- There are several reasons SMART is preferred:
- With SMART, only one MDI is needed for maintenance and relief. This may make it easier to not mix up inhalers.
- SMART reduces asthma attacks by 32% and decreases the risk of:
- Use of the systemic corticosteroids
- Unscheduled medical visits for asthma
- Hospitalizations for asthma
Insurance and SMART
- In Missouri, MO HealthNet preferentially covers inhalers used with SMART.
- MO HealthNet patients can get up to three budesonide-formoterol inhalers per month at a low cost.
- For more information on Insurance & SMART, visit:
Barriers to widespread SMART usage
- Insurance coverage of SMART therapy can vary.
- Patients may be reluctant to stop using albuterol as their reliever medication.
- SMART may require patients to use more medication than a typical monthly supply. Some insurance companies place limits on the number of inhalers that can be dispensed.
- For more information on the barriers to widespread SMART usage, visit: