OBJECTIVES: To examine the sick rate of rheumatoid arthritis in Ukraine in 1996 to 2001. Celecoxib is a new COX-2-inhibitor drug. Randomized controlled clinical trials - RCCTs showed, that celecoxib is safer than non-steroidal anti-flammatory drugs (NSAIDs). To analyse direct medical costs for treatment celecoxib vs NSAIDs with gastroprotective agents in patients with rheumatoid arthritis from the perspective of public health care in Ukraine. METHODS: A decision tree model in Ukraine based on the use of clinical data from literature. Eight RCCTs showed a signifficantly higher incidence of ulcer - the 6-month rates of ulcer were 5,89 % for NSAIDs vs 1,64 % for celecoxib, and for NSAID plus proton-pump ingibitor (PPI) - 1,94%. Only direct costs associated with three alternatives: celecoxib; NSAID only; NSAID plus PPI (six months) were analysed. All prices are expressed in Ukranian hryvnas (UAH). The incremental cost-effectiveness ratio was determined. RESULTS: The sick rate of rheumatoid arthritis from 1996 to 2001 was increased 8,6% per year in Ukraine. The direct costs of celebrex and NSAID only were comparable 905,4 UAH vs 897,5 (1USD=5,2 UAH), but the NSAID plus PPI was significantly more costly 1216,1UAH per one patient. The incremental cost-effectiveness ratio for celecoxib was 1,86 UAH; NSAID plus PPI - 80,6 UAH per 1% of ulcer reduction. The total cost of 100 patients treated with celecoxib was 90540 UAH than NSAIDs plus PPI was 95822 UAH. The threshold analysis suggests that celecoxib would be the dominant therapy if its cost was to decrease by 58%. CONCLUSIONS: The treatment with Celecoxib is more effective and safe than NSAID only, and to be cost-effective than NSAID plus PPI in Ukraine.