OBJECTIVES: To make a pharmacoeconomic assessment of the antiepileptic drugs valproate, lamotrigine and topiramate in idiopathic generalized epilepsy treatment in Russia. METHODS: The pharmacoeconomic assessment was based on the results of a retrospective clinical study “The relationship between treatment with valproate, lamotrigine and topiramate and the prognosis of the idiopathic generalized epilepsies” (A. Nicolson, R.E. Appleton, D.W. Chadwick and D.F. Smith – J. Neurol. Neurosurg. Psychiatry 2004; 75; 75 – 79). 731 of those patients covered by the study underwent monotherapy with one of the anticonvulsants valproate, lamotrigine and topiramate. 52.1 percent of those patients treated with valproate achieved remission. The same figures for topiramate and lamotrigine at 34.6 and 16.7 percent, respectively. RESULTS: The study assessed the direct medical costs of antiepileptic therapy. The analysis was based on the price of the original drugs, Depakine, Lamictale and Topamax. The average daily dose was 1286 mg for valproate, 324 mg for lamotrigine and 256 mg for topiramate. Annual therapy costs per patient were calculated for each drug. Thus, for Depakine, Lamictale and Topamax these were 18,776, 53,217 and 94,374 rubles (1 USD = 26.5 RUR), respectively. The following results were obtained while calculating the cost-effectiveness (CE) coefficient: 36,037.62 for Depakine, 318,664.67 for Lamictale and 272,758.38 for Topamax. Valproate (Depakine) as compared with lamotrigine (Lamictale) and topiramate (Topamax) was shown to have the lowest CE coefficient. CONCLUSION: Valproate may be the most effective antiepileptic drug in anti-IGE monotherapy in pharmacoeconomic terms. The use of valproate as the first-choice drug helps achieve a possible economic gain of 1,003,889 rubles annually for a group of 100 patients increasing cost-effectiveness almost two times.