OBJECTIVES: To evaluate the cost-utility of modern anti-Parkinson drugs in monotherapy early stages of Parkinson’s disease (PD) in the Russian Federation. METHODS: For analysis of market data regarding PD treatment products we used IMS Health Russia database (2014). The target population was newly diagnosed PD patients over 60 years in the early clinical stages according to Hoehn and Yahr functional scale (HY I-III stage). Comparison drugs: pramipexole ER, piribedil CR, ropinirole ER and rasagiline. Utility effect of anti-Parkinson drugs was evaluated by quantitative scale UPDRS – Unified Parkinson's Disease Rating Scale, part II (daily activities) and III (the severity of motor disorders). In the analysis we took into account the costs associated with adverse drugs reactions (ADR). Discounting outcomes and costs was not conducted because the time horizon of the analysis did not exceed 1 year. Bivariate sensitivity analysis (SA) was performed. RESULTS: The cost of the 1st year therapy of compared drugs was: 28,822, 20,810, 57,449 and 54,332 rubles for piribedil CR, pramipexole ER, ropinirole ER and rasagiline respectively. Total therapy cost was estimated by summarizing the cost of therapy and ADR costs. Total costs for comparator drugs constituted: 28,930, 21,009, 57,576 and 54,381 rubles for piribedil CR, pramipexole ER, ropinirole ER and rasagiline respectively. Utility effect of the comparison drugs was: -6.1, -8.2, -0.3, -2.7 for piribedil CR, pramipexole ER, ropinirole ER and rasagiline respectively. In the analysis was found that pramipexole ER has the lowest cost-utility ratio (CUR) – 2,562 rubles for 1 point reduction of daytime activity disruption and severity of motor impairment as indicated by UPDRS scale. CONCLUSIONS: Pramipexole ER has the lowest CUR. SA confirmed these results. Pramipexole ER was the dominant strategy for PD treatment demonstrating higher utility rate at lower costs.