The main problem in conducting lupus treatment is that most drugs for the therapy provided have not been authorized so that they are still included in the class of off-label drugs for the treatment of lupus. The purpose of this study was only to see the impact of side effects of off-label drugs on health costs. This study was conducted using a cross-sectional method by means of a survey using the Naranjo Algorithm instrument (PESO Book) to determine the level of incidence of side effects that exist in LSE therapy using off-label drugs and calculate the health costs of lupus patients. The results showed that the most respondents were in adulthood (19 respondents 47.5%), then the most respondents were female (37 respondents or 92.5%). Data on the incidence of side effects obtained the most respondents in the Probable category (most likely to occur ROM) of 14 respondents or 35%. In addition, data on health costs incurred by more respondents experienced an increase, namely 23 respondents or 57.5%. The research data shows the calculated r value is 0.3044 and the Sig (2-tailed) value is 0.000 with a confidence level (CI) of 0.05. The results of the analysis clearly show that there is a significant relationship between the side effects of using off-label drugs on the health costs of lupus patients, where if the value of side effects experienced by respondents is high, the value of respondents' health costs is also high.