OBJECTIVES: Perform pharmacoeconomic analysis (PHe) of naftidrofuryl in the Russian Federation (RF) in patients aged 66 years and older with peripheral vascular disease, including atherosclerosis of lower limbs arteries (clinical presentation consistent with Fontaine Stage II). METHODS: This PHe is conducted from perspective of public health organizations of the RF and considers only direct medical costs. Horizon of PHe was 240 weeks (4.6 years). Randomized controlled trials and meta-analyzes examining the efficacy, safety and tolerability of drugs in question served as data source. Mean log expression of the maximum walking distance was chosen as clinical efficacy criterion. Quality adjusted life years (QALY) were used as criterion of utility. Resultant Markov had cycle length of 1 week. Assessment of diagnosis and treatment costs in simulated groups was based on government standard of care, taking into consideration the cost of possible angioplasty. Cost-effectiveness (CEA), cost-utility (CUA), budget impact (BIA) and sensitivity (SA) analyses were performed, cost-effectiveness threshold was calculated. Pentoxifylline served as comparator due to presence in standard of care. RESULTS: CER per patient at naftidrofuryl was 2 061 rubl., for pentoxifylline – 4,764 rubl. Naftidrofuryl dominates pentoxifylline in clinical effectiveness and was associated with lower cost, thus ICER  calculation was not needed. Resultant CER did not exceed "willingness-to-pay ratio"  for any of the drugs, thus both  are  relevant to reimbursement system. CUA demonstrated naftidrofuryl superiority both in terms of net impact on QALY, and in terms of utility costs (CUR), CUR of naftidrofuryl per patient totaled 144 992 rubl., pentoxifylline – 213,854 rubl. SA confirmed the stability of these results. BIA indicated that fiscal burden associated with naftidrofuryl, is lower by 183,9 million rubl. per year for every 3,000 patients. CONCLUSIONS: The dominance of naftidrofuryl over pentoxifylline is confirmed in this pharmacoeconomic research effort. Naftidrofuryl dominates in terms of CER, CUR and budget impact.