OBJECTIVES: To understand how PEOR data are used in decision making today and how this may change in future. The methodology and quantity of Pharmacoeconomics and Outcomes Research (PEOR) has advanced considerably over the last decade. With increasing utilization of healthcare, prioritization becomes unavoidable and PEOR evidence should be increasingly valuable to supplement efficacy and safety data for reimbursement and access decisions. METHODS: An internet based survey with 30 items was conducted among decision makers from the USA in April 2010. RESULTS: The 76 respondents represented organizations with national (54%), regional (32%) or local coverage (14%). Membership varied from 50,000 to 100million with a median of 500,000. While 70% of the respondents claimed that PEOR data are used regularly, only 5% indicated coverage by the bylaws of their organizations, and 66% of the users indicated that there is no quality standard for PEOR being used by the organization. The majority of the respondents expected increasing use of PEOR in the future (77%). Organizational requirements to such adoption included ‘more HEOR expertise’, better definitions and standards of methods, in-house data analysis expertise, and regular re-evaluation. Outcomes based evidence is increasingly used in contracting (37%) and 73% expected an increased use in future with the perceived value of reduced financial and clinical risk. CONCLUSIONS: PEOR is used often in decision making in the USA. However, few organizations defined quality criteria for PEOR. There is a consistent expectation that there will be an increasing use of this data, along with a concern regarding a lack of expertise to evaluate this information in their organizations. Improved standards for quality control of such evidence are needed. Another survey will be targeted to the systems and decision makers in selected European countries to compare the utilization of PEOR in the different decision making environments.