OBJECTIVES: To conduct budget impact analysis of neurotrophic and neuroprotective drug cerebrolysin with standard therapy compared to standard therapy only of ischemic stroke of moderate and severe degrees of severity according to the Russian healthcare system. METHODS: The one year budget impact analysis was conducted. We used the pharmacoeconomic analysis method – budget impact analysis and analysis of the direct and indirect costs. For reference, we accepted the exchange rate was 1 EUR = 60,64 RUB. RESULTS: Direct costs include the cost of pharmacotherapy cerebrolysin, the cost of medical emergencies, inpatient and outpatient - polyclinic medical care, as well as the cost of early neurorehabilitation, and indirect costs - the loss of gross domestic product as a result of disability and death, payments for sick leave and disability cost. As a result, the overall costs of standard treatment with cerebrolysin totaled 378 278 RUB (6238 EUR); while the cost to standard therapy was 457 981 RUB (7552 EUR). Reducing the direct and indirect costs was obtained in the treatment group of cerebrolysin, because of lower mortality and reduce days of hospital stay compared with the standard therapy.  CONCLUSIONS: The results of budget impact analysis showed that the inclusion of cerebrolysin in standard therapy of ischemic stroke of moderate and severe degrees of severity can reduce the overall cost of the Russian health care system at 79 703 RUB (1314 EUR) per patient per year.