OBJECTIVES: To evaluate the economic efficiency of 10-years cardiovascular prevention program in primary care of Russian Federation. METHODS: In 1977-1990 in Moscow a large prevention project was realized. The project was realized in two primary care areas of Moscow and included men with baseline age 40-59. One primary care area was intervention area where cardiovascular prevention program was realized during the 5 years, other area was control. Participants of intervention (n=3488) and control primary care areas (n=3168) had the similar age, education and cardiovascular morbidity. The cardiovascular prevention program included preventive counseling for participants with CVD risk factors. All cardiovascular endpoints were registered during 10 years. In this study we calculated the gain of life years saved (LYS) and quality adjusted life years (QALY) in intervention group compared with control group (on 1000 participants) during the 5 years on the intervention and during 10 years of total follow up period. Also we calculate the total cost of the program in the prices of 2008 years. The cost utility analysis was conducted with calculation of cost per gained QALY during 5 years and during 10 year. RESULTS: The number of gained LYS in the intervention group was 45.7 on 1000 participants in 5 years and 139.4 – in 10 years. The number of QALY was 46.2 and 132.7 on 1000 participants in 5 and 10 years accordingly. The total costs were 174,124$ on 1000 participant in 5 years and 237,928$ in 10 years. Cost per QALY gained was 3769$ during the 5 years and 1793$ during the 5 years. The gross domestic product per capita in 2008 was 11,806$. CONCLUSIONS: Cardiovascular prevention program for men aged 40-59 is highly cost-effective and economic arguments can be used for policy-makers.