OBJECTIVE: To conduct an economic evaluation of unfractionated heparin (UFH) compared with low molecular weight heparin (LMWH) enoxaparin in acute coronary syndrome (ACS) treatment. METHODS: Two group patients with ACS. Arm A: 23 patients with unstable angina (UA) - 52.2% and non-Q-wave myocardial infarction (NQWMI) - 37.8% treated by UFH, 200 IU/kg/day. Arm B: - 23 patients, 52.2% in UA and 37.8% in NQWMI treated by enoxaparin 1mg/kg/twice a day. All patients were treated by heparin up to remission achievement. Economic evaluation was done by cost - effectiveness analysis usage. The costs of the treatment and resource utilization items were analyzed. Unit costs were based on detailed data from the Moscow Obligatory Insurance Fond (Jan 2003). The total direct medical costs were calculated as a sum of costs for follows: expenses on medicine and drug using, hospital expenditures, diagnostic and laboratory tests, time allocation. Achievement of stable remission of the process was the effectiveness. RESULTS: The total direct medical costs of Arm A came to 538,960 rubles and expenditures for heparin usage were 10,000 rubles (1.8%) of them. And for Arm B it was 457,072 rubles as total medical costs and 53,146 rubles or 11.6% of them for enoxaparin usage. Stable remission was 65% and 83% for Arms A and B respectively. Serious side effects weren't registered at all. Cost effectiveness (CE) index for both groups was calculated as CE =.The total costs of whole treatment/ Effectiveness (% of remission) CE A = 360.5 rubles/ % per patient. CE B = 239.43 rubles/ % per patient. The Rate of Exchange was 31.5 rubles for USD$1. CONCLUSION: in spite of the high costs for LMWH in compare to UFH this is evidence based way for approaching necessary effect of patients in ACS with investment saving.