OBJECTIVES:  Growth in the Chronic Obstructive Pulmonary Disease (COPD) market in the past two years has been driven by the entry of LAMA/LABA fixed-dose combination products (LAMA/LABAs). The objective of this research was to analyse the assessments of LAMA/LABAs by national HTA agencies across the world. METHODS:  Assessment reports and guidelines from 24 agencies (PBAC, KCE, CONITEC, CADTH, INESSS, MOHLTC, HAS, IQWIG, G-BA, ZIN, AHTAPol, AEMPS, AETSA, Avalia-T, AQuAS, OSTEBA, TLV, NICE, SMC, AWMSG, MTRAC, ICER, CTAF, BCBS-TEC) on LAMA/LABAs published between January 2011 and December 2015, were identified and reviewed. RESULTS: All four LAMA/LABAs assessed received similar recommendations from HTA agencies, apart from in Germany where formoterol/aclidinium and indacaterol/glycopyrronium received higher benefit ratings in some patient subgroups than vilanterol/umeclidinium and olodaterol/tiotropium. In terms of clinical evaluation, all four products showed statistically significant superiority in efficacy against the monotherapy of its components and tiotropium or placebo. All LAMA/LABAs were deemed to have comparable efficacy to each other and to the separately administered combinations. In terms of economic evaluation, LAMA/LABA combinations offered cost saving of about 25-40% to payers compared to the combination therapy using individual inhalers. Overall, the time from regulatory approval to final HTA decision was longer for products which were launched earlier. Indacaterol/glycopyrronium took an average of 7.5 months, while vilanterol/umeclidinium, formoterol/aclidinium and olodaterol/tiotropium took 5, 4 and 2.7 months respectively. The payer dossier review time for the four products were found to be similar. CONCLUSIONS:  The analysis showed that the four LAMA/LABAs were equivalent with each other in terms of clinical efficacy and economic case. Products which were launched earlier took a longer time from regulatory approval to receiving HTA decisions.