OBJECTIVES: The GSK Ellipta portfolio medicines are licensed for treatment of COPD in the UK and is comprised of fluticasone furoate/vilanterol, umeclidinium bromide/vilanterol and umeclidinium bromide.  A budget impact model (BIM) was designed to explore the cost implications of prescribing Ellipta portfolio in appropriate patients versus alternative therapies, in line with clinical guidelines. METHODS: a one-year BIM was constructed to explore financial implications of prescribing Ellipta medicines as alternative treatment options to currently prescribed therapies. The BIM is based on UK prescription analysis, epidemiological and resource data. The BIM uses prescription data to generate patient cohorts and progresses them to more intensive therapy based on estimates of symptoms of  exacerbation  or breathlessness. It also considers medicines optimsation for patients that could benefit from  simplified regimens and estimates the budget impact of moving patients using non-licensed ICS/LABA  to licensed therapies. The model allows definition of treatment progressions, using appropriate Ellipta devices to target bronchodilator or steroid based regimens.  Costs are calculated using  market share of current treatments vs. a scenario in which Ellipta medicines are used. Differences in patient outcomes, efficacy or safety are not explored. RESULTS: It is estimated that the average health economy in the UK has 5,518 COPD patients of whom 2,753 are eligible to be progressed in their medication. In year 1, compared to a base case of utilising the most routinely used existing COPD therapies (100% implementation rate for new incident patients and 50% for all others) would increase spend by £247,704 compared with a reduced budget impact of   -£131,109 if these eligible patients were moved to Ellipta medicines.  CONCLUSIONS: The introduction of Ellipta portfolio in COPD could potentially reduce the budget impact and total spend on COPD therapies by £379,812 in the average UK health economy compared to current prescribing patterns. Funded by GSK