OBJECTIVES: The objective of this study was to estimate incremental Budget Impact (BI) and survival benefit of utilizing lenvatinib for treatment of Radioactive Iodine Refractory Differentiated Thyroid Cancer (RR-DTC) in Russia. METHODS: Epidemiology was derived from Worldbank, and National Oncology Statistics Database*. Current treatment algorithm for Best Supportive Care (BSC) for RR-DTC in Russia comprised of doxorubicin, liposomal doxorubicin, and epirubicin.  Lenvatinib was evaluated using either sorafenib or BSC as comparators. The market shares of the BSC drugs were obtained from the Russian Advisory-board study conducted by Eisai Inc. Safety and efficacy data were obtained from the Phase III clinical trials of lenvatinib and sorafenib. Local tariffs were used for the calculation of drug costs, administration costs and adverse events management costs. An Excel based switching pattern model was developed across a 5-year horizon from the payer perspective in Russia to evaluate the budget impact and survival benefits of including lenvatinib in the treatment mix for management of RR-DTC. RESULTS: Applying metastatic RR-DTC prevalence and mortality rates in population over 18 years of age in Russia; model estimated up to 1,341 patients treated with lenvatinib out of 23,106 eligible patients over 5 years. The BI in years 1,2,3,4 and 5 is RUB 3.0M, RUB 3.9M, RUB 4.0M, RUB 4.1M, and RUB 4.1M. The main cost-offset includes displacement of sorafenib and other more widely used BSC treatments. For these 1,341 RR-DTC patients in Russia, treatment with lenvatinib is estimated to yield an incremental 1,628 Progression Free Survival years over a five year time horizon. CONCLUSIONS: Given the limited number of effective treatment options available to patients with RR-DTC, lenvatinib represents a much needed therapy option for this population. With additional survival benefits, lenvatinib represents an effective and innovative approach to RR-DTC management in Russia.