OBJECTIVES Pseudobulbar Affect (PBA) is a neurologic disorder of emotional expression, resulting in frequent and involuntary episodes of crying and/or laughing. Common neurological conditions associated with PBA include: Alzheimer’s disease, amyotrophic lateral sclerosis, multiple sclerosis, Parkinson’s disease, stroke and traumatic brain injury. Nuedexta® (Avanir Pharmaceuticals Inc.) is the only EMA-approved PBA treatment. The financial impact of introducing Nuedexta to a national healthcare system, including Scotland, has never been formally estimated. METHODS An Excel® based cost-calculator was developed. Prevalence, epidemiology and mortality estimates for causative neurological conditions as well as PBA prevalence in those conditions were sourced from the literature. Unit costs (drugs, hospitalisation etc.) were taken from national databases and standard care treatment mix and resource use were derived from a US claims database. A range of market uptake rates were used with further sensitivity analyses undertaken. RESULTS The estimated cost of standard care in Scotland for PBA is circa £32.4 million annually (circa 22,500 patients). In year 1 following introduction, 67 patients are expected to receive Nuedexta, resulting in a cost increase by £0.1 million to £32.5 million. By year five, 836 patients are estimated to receive Nuedexta, resulting in a projected total annual cost of £34.6 million. Therefore the estimated annual budget impact of Nuedexta ranges from £0.15 million (year 1) to £1.88 million (year 5).  The incremental cost per patient is £2,246. The model was sensitive to changes in uptake rates, cost of background therapy and PBA symptom severity. When patients with moderate to severe PBA symptoms receive treatment, the projected cumulative year 5 budget impact estimate is £7.56 million. CONCLUSIONS The estimated financial impact of introducing Nuedexta in Scotland is modest. Even if more patients are identified, the relatively small incremental cost per-patient of Nuedexta is unlikely to have a major impact on the Scottish NHS.