The wide range of medications complementing standard therapy for psoriatic arthritis (PsA) and ankylosing spondylitis (AS), coupled with the lack of a strict prescribed sequence for their administration that would establish conventional lines of therapy, predetermines a variety of approaches to prescribing medications to patients based on their individual characteristics. At the same time, biological medications and small targeted molecule medications are characterized by relatively high costs, and the primary mechanism for ensuring their accessibility to patients is reimbursement, funded by both federal and regional budgets. Organizing reimbursement implies formalizing the selection of the nomenclature and volumes of medications used. Regional executive authorities have the authority to determine the nomenclature and volume of drugs for outpatient subsidized medicine provision, and senior external specialists play a key role in these processes. This may determine regional differences in the distribution of patients with PsA and AS between alternative drugs. Therefore, it is important to study regional practices for distributing patients with PsA and AS between biological medicines and small targeted molecule medicines, identifying these regional differences as a basis for further improvements in the organization of medicine provision for patients with PsA and AS. Using a developed form, data were collected from 11 constituent entities of the Russian Federation on the distribution of patients with PsA and AS between biological medicines and small targeted molecule medicines, followed by calculation of the average cost of this pharmacotherapy in each region. An analysis of data from 11 constituent entities of the Russian Federation on the distribution of patients with PsA and AS between biological therapy and small targeted molecule medicines revealed the highest demand for the IL-17 inhibitor secukinumab, which is characterized by the highest average proportion of patients on this medicine for both PsA and AS across all 11 constituent entities of the Russian Federation. The average annual cost of treating one patient with PsA and AS across all 11 constituent entities of the Russian Federation was 554,690 rubles and 542,114 rubles, respectively. Based on medicine consumption patterns, five regional groups for PsA and two for AS were formed across the 11 constituent entities of the Russian Federation.