OBJECTIVES: Acute pancreatitis (AP) is associated with significant morbidity and mortality, representing a severe economic burden for healthcare system. Numerous attempts were made to find medications able to inhibit secretion of pancreatic enzymes and/or inflammatory cytokines in patients with AP to prevent further destruction of pancreas. There exist some evidences demonstrating that a cyclooxygenase inhibitor lornoxicam may inhibit secretion of inflammatory cytokines. The objective of the study was to investigate if lornoxicam administration might be clinically and economically beneficial in patients with AP.  METHODS: Patients with AP were admitted in a Moscow hospital in 2010-2011. All of them were treated according to existing Russian standards of AP treatment. Part of patients were administered with lornoxicam iv bid during the first 5 days of hospitalization (16-32 mg a day). The information on the patients was collected using electronic health records (EHR) and then analyzed. Due to differences in baseline characteristics of the groups of patients treated and non-treated with lornoxicam, propensity scores matching technique was used. Logistic regression model was built to calculate propensity to be treated with lornoxicam for each patient. Then mortality rates were compared for the matched cohorts treated and non-treated with lornoxicam. Finally, the cost of one prevented death was calculated. RESULTS: Totally 264 patients were identified in EHR, lornoxicame was administered to 74 patients. Propensity scores adjusted mortality rate was 6.0% for lornoxicam group and 20.0% for control group (p=0.037). Thus, administration of lornoxicam might prevent mortality in 14% patients with AP. The cost of the 5-day course of lornoxicam was 2,602 RUB (78 USD). Therefore, the cost of one prevented death due to AP was 18,586 RUB (556 USD).  CONCLUSIONS: It was demonstrated that intravenous injections of lornoxicam in patients with AP was not only potentially life-saving, but also cost effective, given the low cost of one prevented death.