OBJECTIVES: Bacterial lysates reduce acute exacerbations for patients with chronic obstructive pulmonary disease. The purpose of this study was to conduct a cost-benefit analysis of bacterial lysates from a payer perspective through the results from a Meta analysis and a Delphi panel survey in China. METHODS: A cost-benefit analysis was to project the 12-month health benefits and costs associated with immunostimulation treatments. Acute exacerbations were served as a measure of effectiveness. Treatment effectiveness data were derived from the meta-analysis. Costs were obtained from a Delphi panel survey of treating acute exacerbation for chronic obstructive pulmonary disease in China. One-way sensitivity analysis was used to explore each parameter's impacts on the uncertainty of the results. RESULTS: The group receiving routine care only was dominated by the group with bacterial lysates plus routine care. Sensitivity analysis proved the robustness of the results. For a COPD patient, compared to the routine care as control group, the alternative treatment with bacterial lysates could reduce 1.9 exacerbations in 12 months (WMD, -1.865; 95% CI, -2.128 to -1.603; P<0.00001). The projected 12-month cost savings of a patient receiving bacterial lysates plus routine care was CNY14476. The cost of patients receiving bacterial lysates plus routine care was significantly lower than those receiving routione care only. CONCLUSIONS: For patients with COPD, treatments with bacterial lysates can improve patient outcomes and reduce costs.