Several newly approved agents for asthma together with others seeking approval are expanding the range of therapeutic options for this disease in Brazil and Mexico. Drugs such as the inhaled corticosteroid (ICS)/long-acting beta2 agonist (LABA) fixed-dose combination (FDC) Relvar/Relvare (GlaxoSmithKline/Theravance’s vilanterol/fluticasone furoate) and the anticipated label extension of the long-acting muscarinic antagonist (LAMA) Spiriva (Boehringer Ingelheim/Pfizer’s tiotropium) for asthma are likely to drive market growth. Furthermore, Cinquil (Cephalon/Teva’s reslizumab) and Bosatria (GlaxoSmithKline’s mepolizumab), interleukin-5 (IL-5)-targeting biologics in late-stage development, will add a competitive dynamic to the severe, disease-refractory market segment, which represents a patient population characterized by high morbidity and frequent hospitalizations for whom Xolair (Genentech/Novartis’s omalizumab) is currently the only therapeutic option. Severe, refractory asthma is undoubtedly a burden to the healthcare systems in the countries under study, but it equally represents remaining therapeutic need and therefore ample opportunity for developers. However, the rising cost of the asthma treatment armamentarium will be balanced by increasing coverage restrictions; drug makers must carefully navigate the road to reimbursement in order to optimize uptake.