OBJECTIVES: The purpose of this study was to conduct an economic analysis of clinical effectiveness of antiviral drugs in monotherapy (entecavir, lamivudine, telbivudine, tenofovir, peginterferon alfa-2a) compared with no specific treatment for patients with chronic hepatitis B in Russia.  METHODS: Clinical-economic study was carried out with the Markov model.The duration of one cycle-1 year,the duration of antiviral treatment-5 years.As a measure of utility QALY were used. Due to the absence of Russian studies, a multinational study from 2008 was used. RESULTS: Total cost of one year of treatment of chronic hepatitis B were: lamivudine-35732.97 rubles, for entecavir-96104.00 rubles for tenofovir-103279.55,for telbivudine-116933.75 for peginterferon-alfa-2a-502238.40 rubles. The lowest cost-utility ratio (CUR) was for lamivudine-91159.54 rubles/QALY. The highest CUR is for pegylated interferon alfa-2a and then tenofovir/entecavir-183263.00 rubles/QALY and 176936.58 rubles/QALY, respectively. More cost-effective treatment is to start with the third-line drugs-entecavir/tenofovir.The study showed that the use of entecavir,lamivudine,tenofovir is clinically and economically more effective than using no specific antiviral therapy.The CURs for these tactics is lower than that for the natural course of the disease.More effective from a clinical and economic point of view, for the treatment of chronic hepatitis B is to use as single one of these:entecavir/tenofovir/lamivudine. CONCLUSIONS: The quality of life of patients with chronic hepatitis B without the specific treatment will be lower than that with the antiviral drugs,since without the treatment increases the rate of formation of severe fibrosis in the liver, there is a quicker outcome to cirrhosis and other complications.Lowest CUR is for lamivudine due to the low cost of it,but the high rate of resistance to lamivudine and the need to add additional third-generation drug may increase the cost.The highest CUR is with administering pegylated interferon-alfa-2a and then applying tenofovir/entecavir. It seems economically feasible to begin therapy immediately with the administration of the third generation drug - entecavir or tenofovir.