OBJECTIVES To evaluate the real life practice  of the use of botulinum toxin A (BoNT-A) in post-stroke upper limb spasticity  and the economic consequences of  fair comparisons of the dosing between either abobotulinumtoxinA (Dysport®) or onabotulinumtoxinA (Botox®) or incobotulinumtoxinA (Xeomin®) METHODS ULIS-II is an observational, prospective study, conducted in 84 centers in 22 countries. Of RESULTS For the abobotulinumtoxinA group (N=141) a mean (SD)/median (min-max)dose of 665 U (280)/500 U (150-1500) was injected, for the onabotulinumtoxinA group (N=37) a mean (SD)/median dose of 183 U (99)/200 U (50-500) was injected and for incobotulinumtoxinA (N=15), a mean (SD)/median dose of 235 U (108)/200 U (100-440) was injected. Based on a BoNT-A injection interval of 12 weeks, the annual cost per patient in the UK would be 1,068 GBP for abobotulinumtoxinA, 1,198 GBP for onabotulinumtoxinA and 1,399 GBP for incobotulinumtoxinA. CONCLUSIONS Considering the real life practice of BoNT-A injections and the comparison of treatment groups treated for the same limb segment, this analysis suggests that the use of abobotulinumtoxinA would result potentially in a reduction in the healthcare cost for the treatment of spasticity and that more patients could be treated with abobotulinumtoxinA with a given budget.