I find it's cheaper to use generic albuterol in a nebulizer, both covered by my insurance than to use "puffers" or "inhalers" such as those advertised. Seems inhalers of all types are a tier 3 or 4 drug with a minimum 40 buck copay and they're so expensive they thow you into the gap very quickly. I totally avoid these things in favor of generic meds for nebulizers. I paid a small copay for the machine and I get the abluterol for nothing. Any generic nebulizer meds will be cheaper than those inhalers they keep pushing. I know I may be missing out on some meds that can help but forget it. No way am I spending that kind of money.