OBJECTIVES: To study the current prescription pattern and to analyze the cost of the treatment prescribed to RA patients referred to orthopedics OPD in a tertiary care teaching hospital of South India. METHODS: The study protocol was approved by the institutional ethics committee. Patients  attending  Orthopedic  OPD  for  existing  RA  disease  were  recruited  as  per inclusion  criteria. Written informed consent was sought. Total 100 consecutive rheumatoid arthritis patients (fulfilling the American College of Rheumatology Criteria 1987) were recruited during study period. Study Design: Cross-sectional study. Study Duration: 06 Months (From July 1^st to December 31^st   2014) Study Site: Department of Orthopedics, Government Medical College and Hospital, Anantapuramu, Andhra Pradesh, India. RESULTS: Majority of patients (67%) in the study population were on combination of two DMARDs.  Most frequently prescribed two DMARDs combination was methotrexate and hydroxychloroquine (64%). Average total cost per prescription was found to be 763.39₹, while average hospital and out of pocket expense were 281.12₹ and 482.88₹ respectively. CONCLUSIONS: The drug use pattern in RA was found to be DMARDs based and majority of the cost was borne by the patient. The total increase in cost was due to administration of drugs to treat the adverse drug reaction.  Prospective studies in a larger number of patients are needed to assess the utility of prescription audit and cost analysis of drugs used in RA.