Introduction:
The rapid development of the pharmaceutical industry has increased the need to assess and monitor the use of medicines. Thus, necessitates the importance of monitoring the appropriate use of medicines including antimicrobials.

Objective:
Pharmacoeconomic analysis of pharmacotherapy in the nephrology department at a multidisciplinary hospital.

Methods:
The study is a retrospective analysis of medicine use and expenditure. The study utilized the ABC-VEN analysis of medical use and the WHO-AWaRe-2021 analysis of antibiotic use, to determine the prescription and financial trends of the nephrology department (30 beds) of a multidisciplinary regional hospital (total 844 beds) in Turkestan, Kazakhstan 2018-2021.

Results:
The analyzed costs of drugs included 116 international nonproprietary names prescribed to patients from the nephrology department during the study period. In total, pharmacotherapy costs increased by 52.6% in 2021 compared to 2018. Five INN drugs were purchased without their inclusion in the Kazakhstan National Medicinal Formulary, such as atropine sulfate, sodium bicarbonate, sodium chloride (crystalline salt), nitroxoline, and nitrofural. The pharmacoeconomics analysis of antibiotics usage for 2018-2021 showed a sharp increase in the%age of costs.

Conclusion:
The study showed an increase in funding for pharmacotherapy in the department of nephrology, which increases the availability of medicines. However, the trend in prescribing drugs with poor evidence base level, and the increase in the proportion of antibiotic prescription, require immediate intervention including the utilization of clinical pharmacy services for regular assessment of the pharmacoeconomic feasibility of antibiotic therapy. This will improve the quality of medical care and reduce the financial costs.