OBJECTIVES: To assess impact on the 3-year health care budget of 3 biologic drugs (BD) – abatacept, adalimumab and etanercept – provided for all eligible children with poliarticular juvenile rheumatoid arthritis (JRA) not responding to the standard therapy METHODS: The indirect comparison of the results of randomized controlled trials (RCT) demonstrated that compared BD have approximately the same effect on the rate of disease flares in children with poliarticular JRA. We developed four scenarios assessing direct costs (drugs, medical services and sick leave payments for parents caring for children) bared by the government during 3-years period in base case and in cases of provision of one of compared BD for all children with poliarticular JRA. The hypothesis was that introduction of BD decreases the rate of disease flares and thus reduces related costs. The potential reduction of costs related to disability was not assessed due to the lack of data. The model inputs were derived from Russian cost of illness analysis of JRA and RCTs on the efficacy of BD.  The costs estimation was based on the average wholesale price of BD and reimbursement rates in the compulsory medical insurance system.  RESULTS: The lowest costs are expected in the scenario with abatacept – EURO 63 mln in comparison with EURO 81.62 mln  for etanercept and EURO 134.18 mln for adalimumab. Adoption of BD would reduce the costs of hospital treatment and sick leave payments for the caring parents by 14-17%. Overall the increase of budget spending during 3 year period per 1 patient receiving BD varies from EURO 10,328 (abatacept) to EURO 23,255 (adalimumab). CONCLUSIONS: Supplying with BD all eligible children with JRA requires high additional spending of the health care budget, the least burden is imposed by the adoption of abatacept in comparison with etanercept and adalimumab.