Chronic obstructive pulmonary disease (COPD) is a condition characterized by progressive airflow limitation and decline in lung function. As seen in other developed countries throughout the world, COPD in the U.K is associated with considerable mortality, and morbidity from the disease places a significant burden on the healthcare system and society. Despite the obvious burden of COPD in this country, there is a lack of recognition of COPD among the general public. Healthcare professionals may also fail to recognize the burden of disease, as shown by underdiagnosis and inadequate managemen. A key step in increasing awareness of the burden of COPD is obtaining comprehensive information about the impact of the disease on patients, the health service and society. The large-scale international survey, Confronting COPD in North America and Europe, aimed to address this need for information, by interviewing patients and physicians in eight countries. An economic analysis of patient responses to the survey in the U.K showed that COPD places a high burden on the healthcare system and society with annual direct costs estimated at pounds 819.42 per patient, and indirect cost at pound 819.66 per patient resulting in total per patient costs of pound 1639.08. The cost impact of the disease was particularly marked in secondary care, as a result of inpatient hospitalizations, amounting to 54% of direct costs. These results suggest that reducing patient requirement for hospital care could alleviate the burden of COPD on the U.K. healthcare system. This will require considerable improvements to the way the disease is managed by healthcare professionals in primary care, with earlier diagnosis and the use of interventions aimed at preventing exacerbations and delaying the progression of disease.