The objective. To study the clinical and economic effectiveness of using progestagens in therapy of recurrent pregnancy loss. Materials and methods. We used cost-effectiveness analysis (CEA) with calculation of the cost-effectiveness ratio (CER). We performed a systematic analysis of literature data about the use of dydrogesterone and micronized progesterone in recurrent pregnancy loss. The effectiveness of treatment was estimated in pregnant women, who had a history of spontaneous abortion 3 and more times in succession before 20 wks of gestation. Therapy was regarded as effective if pregnancy was preserved. The duration of modelling - 15 wks (from the 5th to 20th week of gestation). Results. The use of Duphaston has proven to be more effective (2% increase as compared with Utrogestan), also, the Duphaston was a less expensive alternative as compared with the Utrogestan strategy. The CER values that characterize the total cost-effectiveness of therapy administered to one patient were 114 579 and 118 518 rubles for Duphaston и Utrogestan, respectively. Taking into consideration the economic equivalent of a newborn's life cost, which is 7 777 394 rubles, the benefit in using the Duphaston strategy was 666 830 409 rubles, while the corresponding value for the Utrogestan strategy was 651 195 401 rubles. Therefore, in using the Duphaston strategy the benefit was 15 635 008 rubles higher. Conclusion. The use of the Duphaston strategy as a therapy for recurrent pregnancy loss is absolutely economically expedient from the position of its cost-effectiveness.