OBJECTIVES: To develop a Markov model for health-economic evaluations of COPD in Germany that allows estimating the cost-effectiveness of interventions, and to demonstrate the applicability of the model by evaluating a smoking cessation program compared with usual care. METHODS: A seven-stage Markov model (disease stages I to IV according to GOLD classification, post-surgery, post-transplantation and death) was developed to conduct a cost-utility analysis from the societal perspective with a time horizon of 60 years. Exacerbations were subclassified into mild, moderate and severe. Stage-specific probabilities (for smokers and ex-smokers), utilities and costs were estimated based on German data where possible. Uni- and multivariate as well as probabilistic sensitivity analyses were conducted to assess the robustness of the results. A discount rate of 3% was applied to costs and effects. RESULTS: The smoking cessation program was the dominant strategy compared with usual care, as it resulted in an increase in health effects of 0.5 QALYs and a cost reduction of €1000. Sensitivity analyses showed that uncertainty associated with the model result was mostly due to the lack of evidence for costs in early disease stages. CONCLUSIONS: The model allows estimating the long-term cost-effectiveness of interventions for COPD from a societal perspective in Germany. The smoking cessation program evaluated exemplarily was more effective than usual care as well as cost-saving. Although the majority of patients suffer from mild or moderate COPD, data on resource use in Germany are lacking for these early stages. These data are needed to assess the societal burden of the disease and the cost-effectiveness of interventions.