OBJECTIVES: To assess cost-effectiveness of voriconazole compared to other medications recommended in Russia for treatment of invasive aspergillosis (IA) in adults. METHODS: We developed «decision tree» model, comparing 3 alternative first-line therapies in IA: 1) voriconazole, 2), caspofungin, or 3) amphotericin B lipid complex (LC). Efficacy was assessed as the probability of patient survival within 14 weeks of starting treatment. Transition probabilities were calculated on the basis of data derived from published clinical research on IA treatment. Costs were calculated as the sum of drugs cost (based on prices in public procurement) and cost of prolonged stay in hospital due to serious adverse events (based on the average bed-day cost in public health care). In additional model, conventional amphotericin B instead of its LC was administered. Probabilistic sensitivity analysis was performed for both models. Costs were converted to EUROs using the average weighted exchange rate in 2014 (1€=50.815RUR). RESULTS: In the base case model voriconazole was a dominant strategy for IA treatment (per patient survival 0.742 and cost €10,556) in comparison with caspofungin (0.652 and €17,272, respectively) and amphotericin B lipid complex (0.719 and €34,441). Probabilistic sensitivity analysis (1000 simulations) showed the robustness of results. In additional model the willingness-to-pay threshold, at which voriconazole had more chances to be considered cost-effective in comparison with conventional amphotericine B varied from €984 to €21,647 per life saved, depending on the choice of second line therapy. CONCLUSIONS: Voriconazole was shown to be either dominant or cost-effective strategy for treatment of IA in comparison with other therapies recommended in Russian practice.