OBJECTIVES:  To perform budget impact analysis of serelaxin usage on the standard care procedures costs. for 1 year in patients with acute decompensated heart failure in Russia. METHODS:  The survey of Russian cardiology experts with experience in the use of serelaxin was conducted. Pharmacoeconomic model was developed basing on the randomized clinical trials and retrospective data analyses confirmed by the experts that took into account the cost of treatment of patients with acute decompensated heart failure. Budget impact and cost analysis methods were used. For reference, the exchange rate was 1 EUR= 75 RUB RESULTS:  Total number of patients with acute decompensated heart failure in Russia equal 7,9 million people and 2,4 million of them are in terminal stage. The survey of experts revealed that in the real clinical practice only 7% of patients with acute decompensated heart failure were required to administer serelaxin. Total costs for 100 patients with acute decompensated heart failure in standard therapy group were 102 466 €, in standard therapy group with serelaxin administered in 7% of patients costs were 20 589 € higher because of the costs for serelaxin as 2 000 €. Thus, additional costs for readmission within 12 months in serelaxin group were 4 483 € lower and were 61 117 € compared with 64 041 € in standard therapy group. So additional costs per patient for 12 months were 1 499 €. CONCLUSIONS:  Serelaxin in patients with acute decompensated heart failure in real clinical practice conditions requires additional financial resources, thus it lowers the incidence of readmissions with 12 months.