OBJECTIVES: Shortages and poor affordability of essential medicines are global challenges that cause increasing concern. This study evaluated availability and affordability of essential antineoplastics and immunosuppressives in Armenia. METHODS: Compliance of the new Armenian Essential Medicines List (Armenian EML) of 2018 to the World Health Organization Model Essential Medicines List (WHO EML) of 2017 was analyzed. List of medicines registered in Armenia (2018) was analyzed to identify authorized tracer medicines. Data on availability and prices were collected from pricelists of 5 main wholesalers, 3 pharmacy chains and 10 independent pharmacies. Affordability was calculated using methodology developed by WHO and Health Action International; it was expressed as the number of days needed by a person who earns the minimum wage that was set by legislation, to purchase a course of treatment. RESULTS: Only 72.5% of 51 antineoplastics and immunosuppressives and 65.0% of 103 formulations of these medicines listed in WHO EML are included in the new Armenian EML (72.3% and 54.3%, correspondingly, in Armenian EML of 2013); 68.6% of tracer medicines and 44.7% of their formulations are authorized. 49.0% of medicines and 25.2% of formulations were found in wholesalers’ pricelists. Only 19.4% of formulations were available in different pharmacy outlets; the most of chain and all independent pharmacies did not have any tracer medicine. Only 16 of 86 formulations of cytotoxic and adjuvant medicines listed in WHO EML were available on the market; and cost of treatment only for 3 of them was less than 1 day wage. CONCLUSIONS: Only less than half of essential antineoplastics and immunosuppressives and less than one quarter of their formulations recommended by WHO are available on the pharmaceutical market of Armenia. Cost of treatment for the great majority of these essential medicines is unaffordable for those patients who are not covered by the reimbursement system.