OBJECTIVES: The objective of the present investigation was investigation of comparative clinical outcome profile and cost effectiveness of DMARDs, NSAIDs, steroid steroids, herbal drugs. METHODS: It was prospective, longitudinal, open label, parallel group study consisting of four groups with 40 patients in each cohort. The patients were grouped according to the treatment received (DMARDs, NSAIDs, steroid steroids, IL-1β inhibitors). The data regarding health outcome and costs was assessed before and after the three month regimen using HAQ DI, DAS -28, VAS and EQ5D3L and case report form. RESULTS: The mean change in scores of patients subjected to HAQ DI was 0.54 in DMARD; 0.46 in NSAID; 0.50 in steroid drug treated and 0.63 in IL-1β inhibitor treated cohorts. The mean change in scores of patients subjected to DAS-28 was 0.54 in DMARD; 0.52 in NSAID; 0.79 in steroid drug treated and 1.39 in IL-1β inhibitor treated cohorts. The mean change in scores of patients subjected to VAS was 15 in DMARD; 11 in NSAID; 2.4 in steroid drug treated and 39 in IL-1β inhibitor treated cohorts. The mean change in scores of patients subjected to EQ5D3L was 0.26 in DMARD; 0.41 in NSAID; 0.39 in steroid drug treated and 0.72 in IL-1β inhibitor treated cohorts. The mean values varied significantly among all the groups (p<0.01). The average cost effectiveness was 331.48 for DMARD; 206.52 for NSAID; 224.32 for steroid drug treated and 188.41 for IL-1β inhibitor treated cohorts. The QALDs in each treatment group which was 18 in DMARD; 15 in NSAID; 12 in steroid drug treated and 25.5 in IL-1β inhibitor treated cohorts. The incremental cost effectiveness ratio was determined between IL-1β and DMARD and was found to be equal to 0.15. CONCLUSIONS: IL-1β inhibitor therapy is the most cost effective for rheumatoid arthritis in western Indian population.