Objective: CDR is the Canadian central review agency whose advisory body, the Canadian Expert Drug Advisory Committee (CEDAC), makes recommendations for drug reimbursement decisions by public payers. CEDAC is explicitly charged to consider cost-effectiveness in its mandate. A review was conducted of all Reasons for Recommendation to determine if and how cost-effectiveness information was used. Methods: Reasons for Recommendation were identified from the CDR website, from inception (September 2003) to the end of October 2007. Reasons were reviewed by both authors. Each drug indication was categorized as follows: cost-effectiveness was mentioned in the Reasons, incremental cost-effectiveness ratios (ICERs) were considered attractive, and the listing recommendation. ICERs were designated as attractive or not based on either direct comments in the Reasons or indirectly through the restrictiveness of the recommended criteria. Descriptive statistics were performed. Results: There were recommendations for 78 unique drug submissions. Economic evidence was not mentioned in 55% of recommendations (N=44). Cost-effectiveness was mentioned in the remaining 45% of recommendations (N=34). The ICER was considered attractive for 15% of drugs (N=5), with an ICER range from dominant (N=3) to $71K/life year gained. These five drugs had positive listing recommendations. Drugs that were economically unattractive but achieved positive recommendations had an ICER range (where stated) from $50K–$80K/QALY. Economically unattractive drugs with negative recommendations had an ICER range from $18K to $189K/QALY. Conclusion: Cost-effectiveness was often not mentioned in CEDAC recommendations. There appeared to be an acceptability threshold of $50K/QALY with a grey zone extending up to $80K/QALY. However, many drugs were not recommended which had ICERs below these thresholds. Overall, economic information had a limited role for informing Canadian drug reimbursement recommendations.