OBJECTIVES:  To evaluate the cost-effectiveness and budget impact of UMEC/VI compared with Tiotropio (TIO), Indacaterol/glicopirronio (QVA149), Indacaterol/Tiotropio (IND+TIO) and Fluticasona/Salmeterol (FCS) as maintenance bronchodilator treatment in patients aged ≥40 with moderate to severe COPD from the Colombian National Health System (NHS) perspective. Umeclidinium/vilanterol (UMEC/VI) is a fixed dose combination of a long-acting muscarinic receptor antagonist (LAMA) and a long-acting beta 2 receptor antagonist (LABA). METHODS:  An analytical cost-effectiveness model (CEM) of COPD disease progression and a budget impact model (BIM) were developed from the GALAXY model. Data sources were literature reviews and governmental databases; efficacy data was derived from an indirect treatment comparison using a frequentist approach conducted by Huisman et al. The CEM used risk equations per attribute (lung function, exacerbations, symptoms, exercise capacity). Outcomes included mortality, quality of life, and resource utilization. A 20-year time horizon was used and costs and benefits were discounted at 5%. The BIM explored the inclusion of UMEC/VI in the NHS benefit plan, using a 3-year time horizon, including adverse event costs and costs of COPD-related events. RESULTS:  TIO, IND+TIO and QVA149 were more costly and less effective than UMEC/VI and FCS. Costs per additional QALY gained/person treated with UMEC/VI compared to FCS was estimated to be COP$1,325,903 and $17,770,045 for 0.5 years and 20 years of treatment, respectively; indicating that UMEC/VI is cost-effective using the threshold of three times GDP/capita. Furthermore, the inclusion of UMEC/VI will allow the NHS to save COP$16,838,928,466 in the first year (5% UMEC/VI participation rate) to COP$19,325,269,697 in the third year (15% participation rate). CONCLUSIONS:  UMEC/VI is less costly and more effective in this analysis, resulting in possible budget savings when included in the NHS benefit plan for patients aged ≥40 with moderate to severe COPD from the Colombian NHS perspective. Results are maintained in the sensitivity analysis.