OBJECTIVES: COPD is a leading cause of morbidity and mortality in the U.S., and is a major source of healthcare costs. Lifetime costs of COPD and its impact on life expectancy have not been adequately quantified. METHODS: We developed a Markov model to project mortality and costs from COPD over an individual's remaining lifetime. The model profiles patients with diagnosed COPD by sex, age (30, 40, 50, 60, 70, 80 years), smoking status (current, former, never smoker), and COPD severity (GOLD stages I-IV). Changes/transitions for these factors, along with mortality, occur in each one-year model cycle. Data were obtained from published sources and analyses of government survey and claims databases. The model projects direct costs (undiscounted and discounted to 2005 US$ at 3% per annum) and life expectancy (age at death and quality-adjusted life years [QALYs] remaining). RESULTS: For a "typical" COPD patient (60 years old, former smoker, GOLD stage I or II), discounted lifetime costs of COPD were projected to range from $38,000-$74,000 (men) and $43,000-$85,000 (women) for GOLD stages I and II, respectively. Unadjusted remaining life expectancy was 19.6/22.0 years (men/women) for GOLD stage I, and 16.6/19.0 years (men/women) for GOLD stage II. Men/women in GOLD stages I and II respectively had 1.4/2.3 and 4.4/5.3 fewer years remaining in life compared to average 60-year-olds in the general U.S. population. Quality-adjusted life expectancy for men/women was 17.0/18.9 and 12.0/13.7 QALYs for GOLD stages I and II, respectively. CONCLUSION: Lifetime burden of COPD for individuals with the disease is considerable. Costs and life-years lost for GOLD stage II patients are about double to triple for those in GOLD stage I. These results highlight the potential clinical and economic benefits of slowing disease progression.