OBJECTIVE： To investigate the effectiveness and economy of Xinmailong injection combined with basic treatment plan in the treatment of heart failure with reduced left ventricular ejection fraction （HFREF）. METHODS： In prospective randomized central group and open programmatic clinical trials， HFREF patients enrolled in 27 general hospitals during Feb. 2014-Nov. 2016 were divided into control group （n＝253） and trial group （n＝872） according to 1 ∶ 3. Control group received basic treatment， while trial group was additionally given Xinmailong injection intravenously for a treatment course （5 d） at least. Cost-effectiveness analysis was conducted from the perspective of the whole society by using the total response rate of cardiac functional grading， left ventricular ejection fraction （LVEF） improved data， Minnesota heart failure quality scale （MLHFQ） improved data and re-hospitalization rate. RESULTS： Total response rates of cardiac functional grading in control group and trial group were 61.54％ and 81.06％ in 3 months. The improved data of LVEF were about 3.05％ and 7.35％； MLHFQ improved data were 24.39 and 26.63， and re-hospitalization rates were 19.43％ and 10.02％. There were statistical significance in 2 groups （P＜0.05）， which indicated that clinical efficacy of trial group was better than that of control group. Pharmacoeconomics results showed that cost-effectiveness ratio of positive indicators as the improved data of LVEF and chronic cardiac insufficiency QOL scale （MLHFQ） in trial group were lower than control group （189.35 vs. 243.46， 576.38 vs. 614.29）. The cost-effectiveness ratio of re-hospitalization rate and fatality rate in trial group were higher than control group （2 019.61 vs. 925.42）. CONCLUSIONS： Xinmailong injection combined with basic treatment plan is better than basic treatment plan in the treatment of HFREF， and shows a better economy in cost-effectiveness analysis.