OBJECTIVES: In our study we estimated social and economic burden of hepatocellular carcinoma (HCC) in Russian Federation resulting from HCC from the position of public health care system.   METHODS: All types of costs were calculated – direct and indirect (the " cost of illness» analysis), connected with patient treatment at different stage of disease treatment. Epidemiology of ÍÑÑ in Russia was investigated: prevalence, incidence, structure of disease depending on age, disease progression, death rate indicators. The expert opinion of real practice of HCC treatment was collected.   All these methods allowed to estimate the direct and indirect costs of  HCC.   RESULTS: HCC incidence rate was 2.4 patients per 100,000 population (85% in the structure of primary liver cancer). HCC incidence rate index was 8658 patients as of 2008 In the HCC structure intermediate stage prevails – 61%, the terminal and local stages –30% and 9% correspondingly. HCC treatment costs were 2370 bln RUB (€67.7 mln) (2008). Direct medical costs were 2208 bln RUB (€63.1 mln) including in-patient care (90%), out-patient care (6.6%) and diagnostics (3.4%). Indirect costs were 0.161 bln RUB (€4.6 mln) including GDP loses (26%) and payment related with temporary disability (74%) The current  HCC treatment standards do not correspond to international approaches. Very few patients with primary liver cancer get target pharmacotherapy. The analysis of actual practice of managing patients with HCC shows prevalence of drugs with no indications for usage from the point of view of the existing standards and recommendations (form 33% according to regional reimbursement to 58% according to Federal reimbursement).   CONCLUSIONS: Developing of new standards of HCC treatment including target therapy can reduce the cost of illness by reducing off-label use and optimizing the treatment strategy.