OBJECTIVES:  To assess the budget impact of switching adult patients with chronic obstructive pulmonary disease (COPD) from Glycopyrronium bromide and Tiotropium bromide to Aclidinium bromide in the Russian Federation. METHODS:  Information search was conducted in the public domain. Pharmacoeconomic analysis method - budget impact analysis and direct cost analysis were performed. For reference, we accepted the exchange rate was 1 EUR = 74, 70 RUB. RESULTS:  This study was designed for two possible scenarios. The first scenario was included direct comparison COPD treatment with Aclidinium bromide and Tiotropium bromide. The second scenario was based on meta-analyses of Aclidinium bromide, Glycopyrronium bromide and Tiotropium bromide. We started with the calculation of direct cost of the various medications per patient for two scenarios. Cost analysis was conducted on the cost of basic pharmacotherapy, compensation costs for treatment of exacerbations, compensation costs for side effects and adverse reactions for each scenario. The study had a time frame of one year. The total cost per one patient with COPD amounted to 483 EUR (60 doses) and 500 EUR (30 doses) for the Aclidinium group and 585 EUR for the Tiotropium group for the first scenario and 335 EUR (60 doses) and 352 EUR (30 doses) for the Aclidinium group, 412 EUR and 436 EUR for the Tiotropium group and Glycopyrronium group respectively for the second scenario. Further in the present study, based on the results of the “cost analysis” it was revealed that the switching 100 patients to Aclidinium bromide saved 9 379 EUR for the first scenario and 7 667 EUR for the second scenario. CONCLUSIONS:  The budget impact analysis results obtained in this Aclidinium bromide versus others long-acting muscarinic antagonists comparative study demonstrated that Aclidinium therapy resulted in budget saving.