Introduction. The changing conditions of the pharmaceutical business, including changes in the legal and regulatory framework, squeeze state enterprises out of the market, which significantly affects the current health care system as a whole and requires non-standard management decisions – organizing retail trade of drugs and medical products in the medical institutions. Purpose of the study . Starting a retail pharmacy in the medical institution effectiveness evaluation, analysis of the project payback period, prospective modeling of indicators. Material and methods . The studies were carried out according to the results of the analysis of the health care system of FMBA of Russia in Zelenogorsk, which provides medical and pharmaceutical services to 64 000 people living in the city from 2005 to 2018. Results and discussion . A retrospective analysis of the activities of FSUE Federal State Unitary Enterprise Pharmacy № 42 in Zelenogorsk city allows identifying deficiencies in drug supply after the reorganization of the state enterprise during the period of market economy establishment. To solve the problems patients face, it is advisable to obtain a pharmaceutical license for retail trade and open pharmacy retail store in the polyclinics in order to implement an immediate drug supply and provide outpatient departments with the required treatment supplies. The break-even point of such business projects is proved by the example of the Federal State Budgetary Institution Federal Siberian Clinical Center FMBA of Russia (FSRCC FMBA of Russia). There are already four pharmacy retail stores functioning in each of the clinics of FSRCC FMBA of Russia in Krasnoyarsk.