BACKGROUND: Overactive bladder (OAB) symptoms still are not treated in Russian Federation in most cases though several medicines are available at the pharmaceutical market. Direct and indirect costs associated with treatment are important for decision makers in health care.  OBJECTIVES: To conduct cost analysis of solifenacin for OAB symptoms vs absence of pharmacotherapy from the Russian government perspective. METHODS: A mathematical model was constructed to calculate direct and indirect costs associated with OAB for 1 year. Direct medical costs included OAB treatment with solifenacin when relevant, urine pads, treatment of complications and concomitant conditions (CCC) such as urinary infections, skin rash, depression and fractures. Indirect costs included productivity losses in patients of working ages. Data on incidence of CCC for solifenacin treatment and no treatment strategies was derived from clinical studies. One-way sensitivity analysis was performed.  RESULTS: Direct medical costs are higher for soilifenacin strategy vs no treatment: €567 and €483 respectively with cost difference of €84 per patient per year. But solifenacin appears to be cost saving strategy vs no treatment when total costs are taken into account: cost difference is €40 per patient per year in favor of solifenacin. Solifenacin remains cost-saving option until the cost of urinary pads decreases twice from baseline or the solifenacin efficacy becomes less for 15% from baseline. CONCLUSIONS: Solifenacin seems to be an acceptable option for Russian healthcare from the government perspective.