Regardless the pharmacoeconomic evaluation of trastuzumab emtanzine (T-DM-1) has been done before new data concerning T-DM1 effectiveness and also costs data require an update of pharmacoeconomic evaluation. Aim. To update pharmacoeconomic evaluation of T-DM1 in patients with HER2+ breast cancer (BC) and CNS metastases. Materials and methods. Cost-effectiveness analysis along with sensitivity analysis were performed. Direct medical costs and indirect costs (GDP loss) were accounted. Results. At 5 years modeling horizon total cost of trastuzumab emtanzine were higher comparing to lapatinib+capecitabine due to significantly higher overall survival (OS) observed in T-DM1 group. CER OS for T-DM1 was by 21% lower comparing to CER lapatinib+capecitabine (2 099 940 RUR/patient/year and 2 541 879 RUR/patient/year, consequently). Conclusions. The study showed T-DM1 is a cost-effective strategy in patient with HER2+ metastatic BC and CNS metastases.