OBJECTIVES: to perform economic evaluation of three forms of betahistine in patients with vertigo. METHODS: an open-labeled prospective multicenter randomized study was performed in 14 out-patient clinics of Russia. The duration of a study was 30 days. Patients with vertigo were treated with three forms of betahistine (Betaserc, Betaver, Vestibo) in combination with any other medications to the discretion of investigator. The effectiveness criteria were proportion of patients with absence of moderate and severe functional disorders (according to International Classification of Functioning, Disability and Health) and increase of patients’ quality of life rate compared to the initial one (according to EQ-5D questionnaire).  Cost-effectiveness and cost-utility ratios were calculated. RESULTS: Betaver group included 70 (33.2%) patients, Betaserc group – 71 (33.6%) patients, and Vestibo group – 70 (33.2%) patients with moderate vertigo. All patients initially had moderate and severe functional disorders. The proportion of patients without absence of moderate and severe functional disorders up to the end of a study was 54% in Betaver group, 57% in Vestibo group and 69% in Betaserc group. The average difference between initial quality of life rate and the quality of life after the treatment was 19.53, 19.62 and 22.79 (Betaver, Vestibo and Betaserc groups accordingly). Cost of treatment was nearly similar in all groups. The cost-effectiveness ratio according to the criteria “the proportion of patients with absence of moderate and severe functional disorders” was minimal in Betaserc group (8,088.57) compared to Betaver (10,358.17) and Vestibo (8,955.49) groups. The cost-utility ratio according to the criteria “the increase of patients’ quality of life rate compared to the initial one” was also minimal in Betaserc group (244.89) compared to Betaver (286.4) and Vestibo (260.17) groups. CONCLUSIONS: Betaserc seems to be more clinically and economically effective betahistine compared to another two medications in treatment of patients with vertigo.