OBJECTIVES: Within the context of cost-effectiveness evaluations of cancer drug-based therapies, the current project aims to describe trends over time in cost-effectiveness literature, and investigate any potential ‘relationship’ between the pharmaceutical industry involvement in literature and study outcomes. METHODS: This study involves reviewing all eligible cancer cost-effectiveness studies that were published during the five subsequent time blocks 1991-1994, 1995-1998, 1999-2002, 2003-2006, and 2007-2010. Descriptive and association statistical analyses were conducted as appropriate. RESULTS: Of 307 articles for inclusion in the study, 260 (85%) articles have been analyzed to date. While there is a general increase in the publishing journals, the discipline of these has significantly shifted from being mainly “medicine” and/or “hematology/oncology” to being “healthcare science and services”, especially during the last time block. Also, retrospective data is increasingly the major type of data utilized in the studied literature, with lack of meta-analysis data. There has been a significant increase in the external funding of studies as well, both industry and nonprofit. Similar trend was observed with the involvement of paid industry consultation. Surprisingly however, this is associated with an increase in paid consultations with no sponsorships declared. This was also associated with general increasing absence of conflict of interest declaration. Importantly, there has been a significant association between industry funding and reported outcomes of sponsored-drug studies. This did not exist when other type of funding was also involved in the sponsorship. CONCLUSIONS: This is the first analysis of cost-effectiveness literature, whereby, it demonstrated a clear evolvement over the past 20 years in terms of size, study design and characteristics as well as funding. It seems that the absence of a declaration of potential conflict of interest is inappropriately not decreasing in journals, in addition to that financial sponsorship by pharmaceutical industries is associated with favorable result to the sponsor.