OBJECTIVES: CML is among seven nosologies included in the federal program for supply of medicines to patients with rare diseases in the Russian Federation. Currently only first-generation tyrosine kinase inhibitor - imatinib is available to CML patients within this program. However from 25% to 30% of CML patients in Russia have intolerance or develop resistance to imatinib and require second line therapy with dasatinib or nilotinib.  METHODS: This study includes budget impact analysis (BIA) for dasatinib as a second-line CML therapy. Only direct pharmacotherapy costs were considered. Annual treatment cost of dasatinib amounts to 1,720,111 rubles (28,365 €) for chronic phase. Time horizon was set at 1 year. In the baseline scenario it was assumed that 100% of the imatinib-resistant patients are treated with high-dose imatinib in frame of the federal “seven nosologies” program. In the future scenario upon dasatinib inclusion into aforementioned program the percentage of patients that would be possible to switch from high-dose imatinib to dasatinib without increase of the total national CML budget was calculated. Also annual economic impact of providing dasatinib as a second-line therapy to 100% of the eligible patients was estimated. Assumptions regarding adherence to treatment of patients diagnosed with CML and actual medication consumption rate were included into analysis. RESULTS: Budget impact analysis was carried out for a total population of 7100 patients according to the national CML registry in 2015.  Centralized purchase of dasatinib in frame of the federal program could save 463 mln rubles (7,7 mln €)  or 10% of the actual total CML budget in Russia. CONCLUSIONS: With consideration for actual dasatinib use within regional drug provision programs it was demonstrated that 100% of the imatinib-resistant and intolerant patients can be provided with dasatinib as a second line treatment without increase of the total national CML budget in 2014.