OBJECTIVES: New antiretroviral drugs have a major impact on future treatment options for treatment-experienced HIV-patients with antiretroviral resistance. The goal of this study was to perform economic evaluation of maraviroc compared with other new antiretroviral agents, such as raltegravir, darunavir and enfuvirtide for treatment-experience patients with HIV infection in Russia. METHODS: Indirect comparison was performed to assess the relative clinical efficacy and safety of compared drugs, all in combination with optimized background therapy (OBT). A mathematical model was created in Microsoft Excel software to estimate the direct medical costs of: compared drugs, an average OBT regimen and routine outpatient follow-up (including visits to specialists and diagnostic tests). Drug and medical services cost calculations were based on registered prices from the list of vital and essential drugs and financial standards of regional program of national guarantees for the provision of free medical care to Russian citizens in Moscow in 2012, respectively. The obtained results were tested in sensitivity analysis. RESULTS: According to indirect comparison results, there were no statistically significant differences between maraviroc, raltegravir, darunavir and enfuvirtide neither by the undetectable HIV RNA level nor CD4(+) cell-count changes. The rate of adverse events was comparable (except enfuvirtide that has more injection-site reactions). Maraviroc-containing regimen compared with raltegravir-, darunavir- and enfuvirtide-containing regimen is associated with reduced costs and saves an average 177 764.16 rub (€4 209.94), 59 929.92 rub (€1 419.30) and 462 295.92 rub (€10 948.42) per 48 weeks of therapy, and 340 714.64 rub (€8 069.05) and 114 865.68 rub (€2 720.33) and 886 067.18 rub (€20 984.47) per 96 weeks of therapy per patient, respectively. Results were robust in one-way sensitivity analyses. CONCLUSIONS: The analysis showed that maraviroc compared with darunavir, raltegravir and enfuvirtide is a cost-saving treatment option for CCR5 tropic treatment-experienced patients in Russia.