OBJECTIVES: Existing pre-scored multi-attribute health status classification systems do not capture well the typical impairments and fluctuating nature of COPD. This study aimed to develop COPD health profiles that describe the health status of these patients over the course of one year and have these profiles valued by the general population. METHODS: We developed 16 COPD health profiles. Each profile combines a description of the severity of COPD during the stable phase (in terms of symptoms, impact on non-strenuous and strenuous activities, ability to work, anxiety and depression, energy and tiredness) with a description of the exacerbation profile (in terms of frequency, duration, severity of increase in respiratory and non-respiratory symptoms, impact on daily activities, and response to treatment). These profiles were valued by a representative sample of the adult Dutch population using a Visual Analogue Scale (VAS) and Time Trade Off (TTO). All respondents valued 10 COPD profiles during group sessions. Subsequently all respondents received a questionnaire to value another 10 COPD profiles at home. Respondents also valued 4 EQ-5D states. RESULTS: A total of 239 respondents attended the group sessions; 235 completed the questionnaire. Both VAS and TTO values consistently decreased as severity of COPD increased. When including all available responses, mean VAS scores ranged from 0.84 (SD 0.12) for mild COPD without exacerbations to 0.18 (SD 0.12) for very severe COPD with one non-severe and one severe exacerbation per year. Mean TTO values were significantly higher and ranged from 0.98 (SD 0.09) to 0.43 (SD 0.27), respectively. Overall, within each COPD severity stage, the utility decrement for exacerbations increased as the frequency and severity of exacerbations increased. CONCLUSION: This was the first study that generated COPD-specific utilities for health profiles that included the health status during exacerbations. Their compatibility with TTO values of the EQ-5D requires discussion.