OBJECTIVES Bronchiectasis (BE) is characterised by permanent dilation of bronchi with destruction of elastic and muscular components of their walls. Prophylactic antibiotic treatment with acute management of exacerbation episodes is an important component of treatment. Currently there are no approved therapies for BE and inhaled antibiotics and nebulized solutions are used off-label. The objective of this study was to predict clinical and economic consequences associated with BE in adult patients over their lifetime. METHODS We developed a Markov cohort model with a cycle length of 4 weeks from UK healthcare perspective. The model included 4 Markov states: one stable disease state defined as confirmed non - cystic fibrosis bronchiectasis and without exacerbations in the previous 4 weeks and three exacerbation states defined on the basis of severity of exacerbation and associated healthcare resource utilization. Disease state specific costs included costs of drugs, consultations/visits, diagnostic test/procedures, physiotherapy, emergency room visits and hospitalizations. Patient baseline characteristics, exacerbation rates and utilities were estimated from literature. RESULTS The model suggests that ability to reduce hospitalizations and limit impact on quality of life are the major value drivers. The model is also sensitive to baseline risk of exacerbations. A treatment for BE that results in 35% reduction in exacerbation rates and related hospitalizations may result in a reduction of 15.53 exacerbations and 3.23 hospitalizations per patient over lifetime. Reduction in number of hospitalization will result in fewer long-term complications, leading to reduction of 1 death per 600 patients over a period of 10 years. The treatment could result in reduction of medical cost by £10,777 and 0.11 QALY gain per patient over lifetime. CONCLUSIONS Any health care intervention that could reduce the number of exacerbations and related hospitalizations in the BE patients can have significant beneficial impact on clinical outcomes, costs and quality of life.