OBJECTIVES: The conventional economic evaluations (EE) methods may be challenging within the context of genetic testing technologies (GTTs), because: the main outcome a GTT is information, benefits may occur many years after taking the test, non-medical harms might be associated with GTTs, and GTTs may also provide information about the genetic status of the family members of affected individuals. This study was performed to systematically review the methods used in EEs included in Health Technology Assessments (HTAs) of GTTs. METHODS: A systematic search of literature was undertaken to identify HTA reports on GTTs that included EEs in addition to clinical effectiveness results. Studies were reviewed in terms of methods (e.g. type of EE, analytic perspective, cost-effectiveness analysis), and quality (using QHES instrument). RESULTS: Of 342 identified citations, 13 HTAs consisting of 10 model-based and 3 trial-based EEs were included. More than 50% of the included studies had moderate to low quality scores mainly due to not reporting information on basic elements of a standard EE and inadequate management of uncertainty. Cost-effectiveness analysis (CEA) accounted for 62% of included studies. 65% of the studies adopted a third party payer perspective, and 60% used a lifelong time horizon. 75% of CEAs reported intermediate outcomes (e.g. cases-detected). The majority of studies exclusively included technical costs of testing (100%) and therapeutic or preventive interventions (62%). The most frequent variables tested in univariate sensitivity analysis included costs (62%), effects (46%) and transition probabilities (54%). Probabilistic sensitivity analysis was conducted in 31% of studies. CONCLUSIONS: We found several methodological challenges in the reviewed EEs, including: identification of a proper analytical perspective, inclusion of wider range of outcomes and costs, allowing for long-term psychological, ethical and social impacts of genetic tests, and sufficient management of uncertainty. These issues should be carefully considered in future EEs of GTTs.