OBJECTIVES: Fixed-dose combinations (FDCs) of inhaled corticosteroids (ICS) and long-acting beta agonists (LABA) are recommended in moderate to severe persistent asthma and chronic obstructive pulmonary disease (COPD). The aim of the analysis was to evaluate the clinical and economic burden of asthma and COPD in Poland, and assess the impact of poor inhalation technique with ICS + LABA FDCs - which is common with inhalers - reimbursed in Poland on costs and resource use. METHODS: The eligible patient population was estimated based on Polish asthma and COPD prevalence rates, with the proportion of patients receiving FDCs based on available National Health Fund (NHF) data. Costs of inhalers, scheduled and unscheduled health care events were taken from publicly available sources. The analysis was conducted in one-year horizon from the payer and patient perspective (direct costs) and societal perspective (indirect costs). Frequency of poor inhalation technique (occurrence of critical inhaler errors) and the associated increased risk of unscheduled health care events were estimated based on a large (N = 1,664), cross-sectional, observational study, performed in Italy in 2008. RESULTS: In Poland 207,801 adults with asthma and COPD receive an ICS + LABA FDCs annually, of which 56,937 are estimated to have poor inhalation technique. Total direct costs were estimated to be  378 million PLN (91.1 million EUR)and productivity loss costs – 20.4 million PLN (4.9 million EUR) CONCLUSIONS: The clinical and economic burden of asthma and COPD is considerable in Poland and poor inhalation technique is a substantial contributor to costs of unscheduled healthcare events. Novel inhalers with easier inhalation technique may offer clinical and economic benefits in the management of asthma and COPD.