Goal: to conduct the pharmacoeconomic analysis of use of pegylated liposomal doxorubicin (PLD) versus doxorubicin in patients with metastatic breast cancer at a high risk of cardiac events with prior adjuvant anthracycline therapy. Materials and methods: Markov model was developed to estimate such outcomes as overall survival, fatal and non-fatal cardiac events in patients treated with PLD compared to doxorubicin. Treatment efficiency data were derived from clinical trials. The analysis was performed from the point of view of Russian health care system - only direct medical cost such as cost of primary therapy, visit to the doctor and treatment of cardiac events were considered. Results: The analysis demonstrated that use of PLD in treatment of metastatic breast cancer compared to doxorubicin was shown to be cost-effective option for patients at high risk of cardiac events in frame of Russian health care system. Resulting incremental cost-effectiveness ratio (ICER) was 549 831 RUB turned out to be significantly lower than willingness-to-pay threshold equal to 1 648 924 RUB in 2015. Sensitivity analyses showed that results were non sensitive to price for medicines (+/-20%), cost of visit to the doctor (+/-20%), but sensitive to time horizon.