Aim. To assess the pharmacoeconomic feasibility of including lenvatinib in the list of vital and essential drugs (VED) and the state program for providing to the necessary drugs to treat patients with differentiated radioiodine-resistant thyroid cancer. Materials and methods. The design of the study is a retrospective analysis of the literature data. Methods of pharmacoeconomic analysis - cost analysis, budget impact analysis, cost-effectiveness analysis. Results. The replacement of sorafenib with lenvatinib when included in the VED list and the state program for providing the necessary medicines for the treatment of patients with differentiated radioiodine-resistant thyroid cancer will reduce the burden on the program budget. At the size of the target group of 100 people for 3 years, the savings will amount to 43.95 million rubles. The total reduction in the load on the budget will be 11.8%. The results obtained are resistant to an increase in the price of lenvatinib by 19.0% and a decrease in the price of sorafenib by 52%. The average cost of therapy for 1 patient with differentiated radioiodine-resistant thyroid cancer for 1 year with the use of lenvatinib in the first line is 36.0% lower than with sorafenib. The savings for 1 year is 334 911 rubles on the patient. In terms of «cost-effectiveness», the drug lenvatinib dominates sorafenib. The CER value per patient for the year using lenvatinib is 48.7% lower than with sorafenib. Conclusion. From the pharmacoeconomic point of view, the use of lenvatinib in the first line of therapy of radioiodide-differentiated thyroid cancer is preferred in comparison with the use of sorafenib. The inclusion of lenvatinib in the list of vital and essential drugs and the state program for providing the necessary drugs is pharmacoeconomically feasible.