OBJECTIVES: To evaluate the clinical and economic expediency of adding simeprevir (SMV) to pegylated-interferon and ribavirin (PR) versus PR only, or triple therapies with PR plus boceprevir (BOC) or telaprevir (TVR) for treatment of genotype 1 chronic hepatitis C (CHC) virus infection in patients who have failed previous therapy with interferon and ribavirin in Russia. METHODS: A Markov model developed earlier was adapted to the Russian settings. The analysis consists of 2 time periods: 1^st the antiviral therapy (AVT) phase and 24 week follow-up (0-72 weeks) and 2^ndthe disease progression of CHC (72 weeks - lifetime). Incidences of disease progression health-states (decompensated cirrhosis, hepatocellular carcinoma, liver transplant, post-liver transplant and death, associated with high health care costs, high mortality rates) based on available published data. Costs and outcomes (life years, LY) were analyzed for treatment experienced CHC patients from Russian health care system perspective. The incremental cost-effectiveness ratio (ICER) per LY was calculated. Sensitivity analyses were performed. RESULTS: Model results for treatment-experienced patients show that SMV is the dominant treatment  compared to TVR+PR and BOC+PR therapies as more total LYs are saved and less costs accrued. ICER of SMV+PR vs PR was € 22, 967 per LY. Results were robust in sensitivity analyses. CONCLUSIONS: SMV + PR is cost-effective compared to dual PR-therapy and appears the dominant strategy compared to other PI (telaprevir, boceprevir) for CHC treatment-experienced patients in Russia.