We do albuterol because we have a medical card as our secondary insurance and they won't cover xoepenex. I can tell a difference with Luke when he is sick and has to bump up to 4 treatments per day as opposed to the 2 we do normally--he just is more restless. He is too small to tell me if he feels any different, but when he gets to that point, if it does make a difference to him, I guess we will just pay for the xoepenex. But for now, his normal routine of 2 a day does not seem to make much difference and it is not unbearable when he is sick, either, so thus far it has not made sense to pay the extra money.