OBJECTIVES COPD is one of the leading causes of morbidity and mortality worldwide and has a major burden on Russian’s health care system. It’s lead to frequent use of health care resources. The main aim of this study was to describe the direct costs for management of COPD patients with differing degrees of disease severity.  METHODS The methodology for cost of illness analysis was based on a previous Russian study (Avksenteva M.V. et al., 2010). One-year costs were identified by applying cost data to medical information obtained by medical statistical records from 2007. In this study were performed 2 variants of COPD costs. In 1^st variant were used epidemiological data from 2007 and medical resources costs from 2014. In 2^nd variant were used extrapolated epidemiological data and medical resources costs from 2014. Due to lack of actual data in this study was modeled situation – from 2007 to 2012 the overall incidence of adult increased by 12.5%. Medical resources included hospital stays, outpatient visits and ambulance service.  RESULTS The mean annual overall direct health care cost for 1^st variant was estimated to be 54.6 billion rubles ($1.6 billion), for 2^nd variant was estimated to be 61.6 billion rubles ($1.8 billion). The structure of direct costs in Russia was as follows – 77% for hospital stays, 21% for outpatient visits, 2% for ambulance service. COPD exacerbations contributed the major portion of cost and also correlated with disease severity. CONCLUSIONS COPD associated with significant economic burden on Russian’s health care system. There is a striking direct relationship between the cost of care and severity of the disease with hospitalization leading to disease exacerbation being a major portion of cost.