OBJECTIVES: We aimed to assess cost-effectiveness of ceftaroline fosamil (CF) for treatment of hospitalised patients with pneumococcal community-acquired pneumonia (PCAP) in Russia from societal perspective. METHODS: Decision tree model based on results of two 3^rd phase clinical trials (FOCUS1/FOCUS2) was created to assess clinico-economic implications of PCAP treatment with CF vs. ceftriaxone (CS) for society. Day 4 early clinical response (73% vs. 56%, р=0,03) was taken for effectiveness outcome. Direct and indirect expenses associated with initial episode, possible recurrence of PCAP, direct and delayed attributive mortality were taken into consideration. Original drugs costs were extracted from wholesale prices database (www.pharmindex.ru). Cost of therapy was calculated to correspond treatment regiments in selected trials: CF 600mg BID vs. CS 1g QD and common in Russia CS 2g QD. Alternative treatment in case of inefficacy was chosen per experts’ opinion. Indirect expenses evaluation was based on human capital approach (loss in GDP per capita) with 5% discount rate per year. All expenses were converted to US dollars at exchange rate on the date of calculation (June 2014). Uncertainty was explored in a series of one- and two-way deterministic and in probabilistic sensitivity analysis. RESULTS: Respective total expenses of PCAP treatment with CF 600mg BID vs. CS 1g vs. CS 2g QD were as follows: $16548.6 vs. $16894.4 vs. $16972.3, making CF strategy the dominating one. Results were sensitive to change in rate of early clinical response to comparators and duration of CF course. Given willingness-to-pay $12.8 per additional 1% of clinical response (per experts’ opinion) 95.1% and 97.3% of iterations in probabilistic sensitivity analysis recommended CF over CS 1g or 2g QD for treatment of PCAP. CONCLUSIONS: CF 600mg BID is more cost effective then CS 1g or 2g QD in the treatment of hospitalised patients with PCAP in Russia from societal perspective.