To evaluate the cost-analysis of anti-hypertensive drug molecule of Telmisartan, Telmisartan+Hydrochlorothiazide, Telmisartan+Ramipril and Telmisartan+Amlodipine versus marketed brands in patients with Chronic Hypertensive treatment, from the perspective of the Andhra Pradesh rural and town Health Systems. A cost effective analysis, costs of treating and managing the disease and utilities were obtained from analyzing 650 prescriptions of hypertensive patients in Punganur region of rural and town areas. More repeated and most prescribed drugs were selected for cost analysis. The source of information was collected from Outpatient department of Spandana Hospital, Punganur and later follow-up was done at their respective homes. The cost-effectiveness analysis was expressed as a cost of different brands for OD for 90 days treatment. Based on the prescription review Telmisartan 20/40mg and its combination of Hydrochlorthiazide 12.5mg, Ramipril 5mg, Amlodipine 5mg were more repeated and hence were selected and cost of different brands were compared and expenditure of rural and town area people with co-prescribed drugs was also compared in cost analysis study. The study result shows cost of different marketed brand of Telmisartan and its combination drug shows brands availability of less cost and high cost medication. This study will conclude that it might be helpful to the healthcare professionals to prescribe low cost drugs available in market especially for long-term prescription and improve economical status of hypertensive geriatric patient and study reveals the status of rural health compared to urban area