OBJECTIVES:  To evaluate the economic burden exacerbations due to COPD in the Brazilian private healthcare system. METHODS:  The Orizon database is an administrative database containing over 18 million lives of the Private System. Eligibility criteria were patients with ≥40 years with the ICD-10 codes: J41, J410, J411, J418, J42, J43, J431, J432, J438, J438, J439, J44, J440, J441, J448, J449 from 2010 to 2015. A total of 1755 patients were identified and costs related to hospitalizations or outpatient treatment were analyzed using an exchange rate of 1 USD = 3.23 BRL. RESULTS:  From 2010 to 2015 we observed an increasing cost per event (inpatient and outpatient), ranging from USD 4,228,10 in 2010 to USD 9,398.72 in 2015. Raising costs may be explained, at least in part, because of Brazilian annual currency inflation. The direct medical costs of hospitalized patients were much higher than outpatient treatment. The mean outpatient exacerbation treatment cost was USD 102.61 while the inpatient treatment, the mean cost was USD 9,659.05 per event. The mean yearly direct medical cost per COPD patient was USD 5,891.04 in 2010 (n = 239); USD 6,079.62 in 2011 (n = 302); USD 8,119.59 in 2012 (n = 414); USD 8,637.42 in 2013 (n = 459); USD 11,536.36 in 2014 (n = 475) and USD 13,181.13 in 2015 (n = 574). The rate of events per patient were similar among the years, ranging from 1.39 to 1.50 event/year. CONCLUSIONS:  The treatment cost of COPD exacerbations are raising each year in the Brazilian private system. Due to high annual costs per patient, especially COPD severe cases that may require more often hospitalizations, maintaining the disease under control may save resources for health plans.