OBJECTIVES: Budget impact analysis of teriflunomide inclusion as first-line disease modifying therapy (DMT) for patients with relapsing-remitting multiple sclerosis in Russia. METHODS: Analysis was conducted with the time horizon of 5 years. Scenarios, that were considered: existing, in which teriflunomide isn’t financed and patients receive interferon beta-1a (i.m. or s.c. injection), interferon beta-1b, glatiramer acetate and natalizumab, and new scenario, in which teriflunomide is financed by government. Total costs include: costs of DMT and administration, costs of diagnosis and monitoring of MS, costs of relapse treatment. Changes in the use of different DMTs, due to switching from one drug to another were taken into account in the analysis. In the models, patients are switching to the new treatment gradually. RESULTS:  We have created budget impact model assuming that, in new scenario, teriflunomide will be received by the patients with EDSS, that has increased within the scope from 0,5 to 1,49 (11,01%). For natalizumab 2 groups of patients were chosen: patients in whom EDSS rate has increased by 1,5 and more and there was minimum one relapse per year (1,50%) and patients in whom EDSS rate has increased within the range from 0,5 to 1,49 and there was minimum one relapse per year (7,39%). In new scenario, natalizumab is prescribed for the first group of patients, in existing scenario, natalizumab – for the both groups. It was calculated, that if teriflunomide is not included into financing, total costs of patient management are (costs calculated according on Russian National Bank currency exchange rate on 25.05.2016) 201,880,300€ (2017) and 225,146,056€ (2018). Inclusion of teriflunomide causes total costs of patient management - 198,691,951€ (2017) and 218,649,833€ (2018). CONCLUSIONS: Inclusion of teriflunomide into governmental financing causes total cost saving for federal budget of 3,580,550€ (2017) and 6,890,437€ (2018).