OBJECTIVES:  Chronic immune thrombocytopenia is a rare disease with an annual incidence of approximately 1.6-3.9 per 100,000 and a prevalence of 4.5-20 cases per 100,000 in the world. According to published clinical trials, thrombopoietin receptor agonists (TRA) - romiplostim and eltrombopag are effective at increasing platelet counts in patients with chronic immune thrombocytopenia. Indirect comparison provided by manufacturer of eltrombopag for the National Institute for Health and Clinical Excellence (NICE) did not show statistically significant difference in the rate of durable or overall response between eltrombopag and romiplostim. The aim of this study was to determine the comparative health care costs of therapy with TRA eltrombopag and romiplostim in adult patients with chronic immune thrombocytopenia in Russian Federation. METHODS:  An Excel-based model was developed to calculate the annual cost of eltrombopag compared with romiplostim in an average patient treated for chronic immune thrombocytopenia. Calculated costs covered drug acquisition, drug administration, monitoring patients, rescue therapy and management of bleeding. Costs were assessed for 2015 on the basis of registered drug list prices and official tariffs for medical services. Costs were converted to EUROs using the exchange rate 1€=74.6907₽. RESULTS:  The annual total costs of romiplostim treatment is € 56,306.93 per person, the average annual cost of eltrombopag is € 20,369.63. An average annual cost savings per patient is € 35,937.30 (64%) in favor of eltrombopag. CONCLUSIONS:  Eltrombopag being comparably beneficial with romiplostim in chronic immune thrombocytopenia is less costly for Russian healthcare system.