Asthma affects over 20 million (8%) of adults in the United States (US) each year.1 2 As with many chronic conditions, poor control can be attributed to low medication adherence and a reduced quality of life, and can translate into a high burden on the healthcare system and economy.3 4 Of importance is cost-related medication nonadherence, as people face heavy financial barriers to accessing US healthcare, on top of the chronic condition itself posing a major financial burden. Prescribed medications make up a considerable proportion of chronic disease spending in the US, particularly for asthma-related spending (~50% of asthma spending).4 Therefore, efforts to reduce cost-related medication nonadherence not only lessen the financial burden on the US health system but also support people’s ability to improve their disease symptoms. Recent research looking at cost-related medication nonadherence among people experiencing chronic disease has focused on coronary heart disease,5 liver disease,6 and chronic obstructive pulmonary disease (COPD)7 for example, but less so for asthma. Therefore in this issue of Thorax, Hung et al 8 fill the knowledge gap by conducting a study investigating the burden of cost-related medication nonadherence among a representative sample of 30 793 people with current asthma in the US. Using questionnaire data from the National Health Interview Survey (NHIS) from 2011 to 2022, the authors were specifically interested in examining the yearly trends in prevalence of cost-related medication nonadherence, the factors associated with cost-related medication nonadherence, and the association …