OBJECTIVES: Anti-cancer drug formulary has been managed by the government in Korea and needs to be updated for better clinical outcomes. This study was to evaluate current anti-cancer drug formulary focusing on pancreatic neuroendocrine tumors (PNET) and then propose the new formulary reimbursement criteria. METHODS: The drugs on the formulary and the drugs approved for the treatment of PNET were reviewed whether their use and reimbursement was appropriate in the view of the evidence-based approach. The oncology textbooks and clinical practice guidelines were reviewed also. PubMed search for the primary drug literature was performed with MeSH terms (pneuroendocrine tumors, pancreatic neoplasms, islet cell adenoma, islet cell carcinoma, and gastro-enteropancreatic neuroendocrine tumor) and the limits (clinical trial, and publication date to April 30, 2011). Published clinical research data were critically rated with the pre-determined literature evidence strength levels and the new formulary was proposed. RESULTS: Only one anti-cancer drug (sunitinib) was approved in Korea, although it was not proposed as a first-line in the clinical guidelines (NCCN, ESMO) and a textbook (Abeloff’s). Although it was not on the national formulary list, a recently published randomized controlled phase 3 trial would support its use in a certain type of PNET as a primary chemotherapy. The already listed drugs revealed to be evidence-supported but with relatively weak strength levels. National formulary appeared to be reformulated with refined criteria (drug dosage and cancer types, etc). CONCLUSIONS: Sunitinib should be listed on the national anti-cancer drug formulary with a restricted reimbursement criteria of “treatment of unresectable or metastatic, well-differentiated pancreatic neuroendocrine tumors with disease progression in adults” as described in the approved indication and pivotal clinical research data. Next step of the research of this area would be to examine clinical outcomes with this formulary change.