BACKGROUND: The thrombopoietin receptor (TPOr) agonists are recommended as a treatment option for idiopathic thrombocytopenic purpura (ITP) in adults who have had a splenectomy and whose condition is refractory to other treatments (corticosteroids, intravenous immunoglobulins or splenectomy), or as a second-line treatment in adults if splenectomy is not an option. Two TPOr agonists are currently approved for use in ITP: romiplostim, which already has registered price in the vital and essential drug list (VEDL), and eltrombopag, not yet included in VEDL. OBJECTIVES:  to estimate the budgetary impact of 2 alternative treatment scenarios in adult patients with ITP eligible for TPOr agonists therapy over a 5-year period. METHODS:  A model was developed in Microsoft Excel software to estimate the impact of eltrombopag (alternative scenario) on Russian health care budget vs romiplostim as the only drug in TPOr agonists purchases (baseline scenario). Gradual increase of eltrombopag share in state purchases from 20% to 50% within 5 years was considered. The estimated number of patients eligible for TPOr agonists therapy was calculated based on the official national statistical data and clinical trials. Drug acquisition and administration costs were derived from registered maximal drug prices list and regional tariffs in 2015. RESULTS:  The introduction of eltrombopag with market shares increase from 20% up to 50% in 5 years leads to average budget savings of healthcare system, which amounted to: € 1,768,763 in the first year and € 6,501,398 in the fifth year, for treating from 556 to 816 patients with ITP, respectively. The cumulative budget savings over 5 years were € 22,484,003, or 25.7%. CONCLUSIONS:  Inclusion of eltrombopag in VEDL followed by its state purchases can significantly reduce budgetary spendings for the chronic ITP therapy.