The Cost of Montelukast: Is It Worth the Price for Asthma Control?

Montelukast isn’t expensive compared to other asthma medications-but is it worth what you’re paying? If you’ve been handed a prescription for montelukast and seen the price tag at the pharmacy, you’re not alone. Many people wonder: is this drug really helping, or am I just paying for a brand name with no real advantage?

What Montelukast Actually Does

Montelukast, sold under the brand name Singulair and as a generic, is a leukotriene receptor antagonist. It doesn’t open your airways like albuterol. Instead, it blocks chemicals called leukotrienes that cause inflammation and tightening in your lungs during an asthma attack. Think of it like turning down the volume on your body’s allergic response.

It’s taken once daily, usually at night. It’s not for sudden asthma flare-ups. You take it to prevent them. It’s also used for allergic rhinitis-runny nose, sneezing, itchy eyes-especially when those symptoms happen along with asthma.

Studies show montelukast reduces asthma exacerbations by about 30% in children and adults over six months of consistent use. That’s not a cure, but it’s meaningful. Fewer emergency visits. Fewer nights waking up coughing. Less reliance on rescue inhalers.

How Much Does Montelukast Cost?

In Australia, as of November 2025, the cost depends on whether you’re using the brand or the generic, and whether you’re on the Pharmaceutical Benefits Scheme (PBS).

With PBS subsidy, the out-of-pocket cost for a 28-day supply of generic montelukast (10 mg tablets) is $7.30 for concession card holders and $31.60 for general patients. Without PBS, the same supply can run $40-$60 at a private pharmacy.

Compare that to other controller medications:

Notice something? Most asthma controller meds cost the same under PBS. That’s because Australia’s subsidy system caps prices for essential medicines. The real difference isn’t in the price tag-it’s in how the drug works, how easy it is to use, and how well it fits your life.

Why People Choose Montelukast Over Inhalers

Not everyone can use an inhaler properly. Kids, elderly patients, people with arthritis, or those who panic at the thought of inhaling medication often struggle. Montelukast is a pill. No coordination needed. No timing pressure. Just swallow it.

Parents of children with asthma love it. No more fighting over inhaler use before school. No more forgetting to shake the inhaler or hold breath after puffing. One pill at bedtime, and the child sleeps through the night.

It’s also a good option if you have exercise-induced asthma. Some people take montelukast before a workout and avoid needing a rescue inhaler altogether.

And for people with both asthma and allergies, it’s a two-for-one. It reduces nasal congestion and sneezing, which often trigger asthma symptoms. You’re treating two problems with one pill.

When Montelukast Might Not Be Worth It

But here’s the catch: montelukast doesn’t work for everyone. About 30-40% of adults and 20-30% of children don’t respond significantly to it. If you’ve tried it for 6-8 weeks and still wake up coughing or need your inhaler more than twice a week, it’s not working for you.

It’s also not as strong as inhaled corticosteroids. If your asthma is moderate to severe, montelukast alone won’t cut it. You’ll still need a steroid inhaler. In those cases, montelukast is just an add-on-and add-ons cost extra.

And then there’s the mental health risk. The FDA and TGA have issued warnings about neuropsychiatric side effects: depression, anxiety, nightmares, suicidal thoughts. These are rare-less than 1 in 1,000-but they’re serious. If you or your child start feeling unusually down, agitated, or have trouble sleeping after starting montelukast, talk to your doctor. Don’t ignore it.

For people with mild, well-controlled asthma, montelukast might be overkill. If you only need an inhaler once a month, why take a daily pill with potential side effects? Simpler is better.

Is the Generic Just as Good?

Yes. The generic version of montelukast is chemically identical to Singulair. It’s made by the same manufacturers, under the same quality controls. The only differences are the color, shape, and inactive ingredients-like fillers or coatings-that don’t affect how the drug works.

There’s no clinical evidence that brand-name montelukast is more effective. The only reason to pay more for Singulair is if you have a rare allergy to one of the generic’s fillers-which is extremely uncommon.

In Australia, pharmacists automatically substitute generic montelukast unless the doctor writes “dispense as written.” Most people don’t even know they’re getting the generic. And they shouldn’t care.

Who Benefits Most From Montelukast?

Montelukast makes the most sense for:

• Children aged 2+ with mild persistent asthma who struggle with inhalers
• Adults with allergic rhinitis and asthma together
• People who can’t coordinate inhaler use due to age, dexterity, or anxiety
• Those with exercise-induced asthma who need prevention, not rescue
• Patients already on low-dose inhaled steroids who need a little extra control

It’s less ideal for:

• People with moderate-to-severe asthma without a steroid inhaler
• Those with a history of depression or mental health conditions
• Anyone who doesn’t take it daily-it only works with consistent use
• People who respond well to inhalers and have no trouble using them

What to Do If You’re Paying Too Much

If you’re paying more than $31.60 for a month’s supply without a concession card, check if you’re eligible for PBS. You might not know you qualify. If you’re over 65, on a pension, or have a healthcare card, you’re covered.

If you’re not on PBS, ask your pharmacist about the “Safety Net.” Once you spend a certain amount on PBS medicines in a year, your co-payment drops to $7.30 for the rest of the year. Many people don’t realize this kicks in automatically.

Also, compare prices. Some pharmacies offer generic montelukast for as low as $28 out-of-pocket even without PBS, especially if you buy in bulk or use loyalty programs.

Final Answer: Is Montelukast Worth the Price?

Yes-if it works for you.

At $7.30 to $31.60 a month under PBS, montelukast is one of the cheapest asthma controllers available. It’s easy to take. It helps many people sleep better, breathe easier, and avoid the ER. For kids, it’s often the only practical option.

But it’s not magic. It won’t fix severe asthma. It won’t help if you skip doses. And it carries a small but real risk of mood changes.

If you’ve tried it and feel better, it’s worth every cent. If you’ve tried it and feel no difference-or worse-then it’s not worth the cost, even if it’s cheap. Talk to your doctor. Try a different approach. Your asthma control shouldn’t depend on luck. It should depend on what actually works for you.

If you’re unsure whether montelukast is right for you, ask your doctor for a trial. Track your symptoms, rescue inhaler use, and sleep quality for four weeks. Then decide-not based on price, but on results.