INTRODUCTION Chronic obstructive pulmonary disease (COPD) is one of the most common chronic noninfectious diseases. The clinical management is determined by patient assignment to the severity stage of the disease in accordance with the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines. OBJECTIVES Our aim was to determine the economic implications of changing GOLD guidelines (2007, 2011, and 2017 updates) and their impact on the direct costs of pharmacological treatment of

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... patients diagnosed with COPD. PATIENTS AND METHODS This analysis was based on data provided by a group of 298 out of 500 randomly selected primary care physicians in Poland (response rate, 59.6%). Each primary care physician provided information on 10 consecutive patients with COPD. These data were used to simulate the economic consequences of the 2007, 2011, and 2017 GOLD guideline updates. RESULTS Regardless of the GOLD guidelines used, pharmacotherapy of patients with a very severe form of COPD was most expensive. Pharmacotherapy costs would be reduced with each subsequent guideline. In the same group of 2597 COPD patients, the average monthly cost of the first‑line pharmacotherapy as well as the overall costs of pharmacotherapy (first- and second‑line) per patient would be the lowest when applying the therapeutic regimen in accordance with the 2017 GOLD guidelines. CONCLUSIONS Implementation of 2011 and 2017 GOLD guidelines, as compared with the 2007 update, would result in a reduction of direct costs of COPD treatment.