OBJECTIVES: COPD cost of illness assessment and its dependence on GOLD stage or duration of hospital admission. METHODS: The sample consisted of 186 elderly COPD patients. Chest physicians conducted follow-up and financial data were obtained from administrative registry. Time horizon was one year and Health Insurance Fund perspective was selected. Included clinical endpoints were disease exacerbation and hospital admission. Economic data included all inpatient COPD-related medical goods and services consumption, and outpatient drug utilization. We excluded medical costs which did not arise from COPD. RESULTS: An average elderly COPD patient imposed €1745.41 of costs annually to the national health care budget . Severity grade (GOLD stage) and duration of all hospital admissions were significantly and directly correlated with overall cost. Expenses structure per year was: €14.54 outpatient care, €126.97 inpatient drug consumption, €377.98 hospital admission (Intensive Care Unit admissions and specialist consultations included in daily price), €133.5 imaging diagnostics, €111.43 laboratory analysis, €26.67 therapeutic interventions, €70.32 consumables, €884 outpatient drugs consumption.  Most expenses originating from drug acquisition were due to antibiotics prescribed for curing infections and mucolitics and antihistamine drugs consumption. Average number of hospitalizations per person was 1.45 with a duration of 12.84 days. Fifteen persons deceased. Average number of outpatient visits was 2.71 per person. CONCLUSIONS: Overall burden of COPD is mostly driven by outpatient drug consumption and exacerbations leading to hospital admissions. Relative relevance of drug acquisition expenses in our country is higher than in high-income societies, because of still significantly lower human labour wages in the area. Pattern of diagnostic procedures requested and ATC drug classes consumed remains similar and comparable in most countries. More in-depth research of indirect COPD attributable costs e.g. lost productivity, absentism, premature death etc, will be needed in the future.