Diabetic retinopathy (DR) is one of the main reasons of vision loss. Traditional treatment provides insufficient control of disease and adverse events. New drug ranibizumab usage in treatment of DR opens new opportunities in treatment of DR. OBJECTIVES: To provide pharmacoeconomic assessment of ranibizumab in DR treatment in the Russian Federation.  METHODS: Comparative modeling cost-effectiveness (CEA) and budget impact (BIA) analyses based on clinical trials results  were conducted. CEA with 1 year time horizon for basic group patients and BIA with 5 year time horizon for high risk vision loss patient group. CEA considered only direct costs (DC), while BIA dealt with both DC and indirect costs (IC). 1 EURO = 40 RUB.  RESULTS: Annual total costs (TC) per patient (PP) for ranibizumab treatment (8 injections on the average) approached 9786 EURO. Annual TC for LC treatment were 440 EURO PP. Ranibizumab provides 6,1 letters vision improvement on the average, while LC – 0,8 letters. Cost-effectiveness ratio (CER) for ranibizumab was 1604 EURO per letter, for LC CER was 550 EURO per letter. ICER was 1764 EURO per additional letter. Second scenario included DR patients going blind in 5 years on LC treatment, while on ranibizumab treatment they could keep their eyesight. TC over 5 years for ranibizumab treatment (13 injections on the average) were 15225 EURO PP. TC over 5 years on LC were 27327 EURO PP, including IC due to vision loss – 25250  EURO. BIA results have shown that ranibizumab treatment for high-risk vision loss DR patients group provided 9 616 EURO (discounted at 3,5%) cost-saving PP in comparison with LC treatment. CONCLUSIONS: Ranibizumab is highly effective costly treatment that demands additional consideration for administration in common DR patient group, while it seems to be cost-saving in DR patient group of high-risk vision loss.