Objective. To evaluate the use of dienogest for specific therapeutic treatment of endometriosis in comparison with dydrogesterone and gonadotropin-releasing hormone (GnRH) agonists. Material and methods. This pharmacoeconomic evaluation of dienogest use was performed by using cost-minimization analysis. Six-month treatment costs were calculated for treatment of endometriosis with dienogest, dydrogesterone and GnRH agonists (leuprorelin, triptorelin, buserelin and goserelin) with add-back therapy (drospirenone and estradiol). Costs were calculated for a period of 6 months. Average prices for evaluated alternatives were taken from IMS Health retail report (July 2015). One way sensitivity analysis was conducted for assessment of how fluctuations in drug prices can influence on final calculations. Results. The costs of endometriosis treatment per patient for six months were 54 864 rub for leuprorelin, 55 398 rub for triptorelin, 28 794 rub for buserelin, 58 926 rub for goserelin, 18 540 rub for dydrogesterone and 14 201 rub for dienogest. Dienogest is a cost-saving option for treatment of endometriosis in comparison with other alternatives. One way sensitivity analysis demonstrates that possible drug price changes have small impact on this conclusion. Conclusion. The use of dienogest for endometriosis treatment in Russia is as effective as use of GnRH agonists but can lead to significant cost savings. Dienogest is more effective and also less costly in comparison with dydrogesterone. Thus, wider use of dienogest for endometriosis treatment in Russia can lead to considerable budget savings.