OBJECTIVE： To provide reference for optimizing gout drug therapy plan. METHODS： A total of 107 patients met gout clinical diagnosis criteria in the Affiliated Hospital of Putian University during Jul. 1st， 2016- Jul. 1st， 2017 were divided into group A and B according to carrying out HLA-B*58：01 gene detection or not. Group A was divided into positive and negative subgroup according to the results of gene detection. Positive subgroup was given febuxostat 40 mg， qd. Negative subgroup was given allopurinol 300 mg， tid with a treatment course for 2 weeks， the level of uric acid was detected after a treatment course； febuxostat was given instead if the level of uric acid was not up to the standard. Group B was given allopurinol； after a treatment course， the level of uric acid was detected； febuxostat was given instead （usage and dosage as group A） if the level of uric acid was not up to the standard. Both groups were treated for 6 months. The levels of uric acid were investigated in 2 groups before and after treatment so as to evaluate up-to-standard rate of treatment. European 5-D health scale of 2 groups were followed up with telephone to calculate therapeutic efficacy by QALY. Cost-effectiveness of 2 groups were calculated， and sensitivity analysis was conducted. RESULTS： Before treatment， there was no statistical significance in urine acid levels between 2 groups （P＞0.05）. After treatment， urine acid levels of 2 groups were significantly lower than before treatment with statistical significance （P＜0.05）. Therapeutic effectiveness was 0.818 QALY in group A and 0.808 QALY in group B， without statistical significance between 2 groups （P＞0.05）.  The cost of group A was 3 932.46 yuan， and that of group B was 2 174.92 yuan. Cost-effectiveness ratio of 2 groups were 4 807.41 and 2 691.73， and group A was significantly higher than group B. The therapy plan of group B showed that cost-effectiveness advantage. Sensitivity analysis supported the results. There was no statistical significance in the incidence of ADR between 2 groups （P＞0.05）. CONCLUSIONS： It shows cost-effectiveness advantage to directly use allopurinol without gene detection in gout patients.