OBJECTIVES: To compare the ways pharmacoeconomic (PE) guidelines in European and North American countries define the societal perspective for economic evaluations. METHODS: Full-text country-specific PE guidelines were obtained via the ISPOR website and where possible cross-referenced with Health Technology Assessment (HTA) agency recommendations. The following countries were selected for comparison: Belgium, Canada, Finland, France, Italy, Norway, the Netherlands, Portugal and Sweden. The cost categories considered for the societal perspective were assessed and compared between country guidelines. RESULTS: PE guidelines from eight of the selected countries identified specific cost categories for the societal perspective. Guidelines agreed that the direct costs associated with this perspective included costs to the health service, costs to other publicly funded services and costs to patients/family. Costs of time lost by family/unpaid carers was considered by 6/8 guidelines, which differed in assigning the cost as direct or indirect. There were differences in the indirect costs considered; costs of time lost by patients was only considered by 2/8 guidelines. Intangible costs were considered by 4/8 guidelines, although it was generally accepted that these should be accounted for in the outcome measurement rather than through costs. Productivity loss was considered as an indirect cost by nine guidelines; however the preferred method of derivation differed between guidelines: 2/9 guidelines preferred the Friction Cost Method (FCM) and 3/9 guidelines preferred the Human Capital Method (HCM). Moreover, there were differing views regarding the types of productivity loss to include: Portugal recommended consideration of employee-related loss only, whereas Canada also included loss to the employer associated with hiring new staff. CONCLUSIONS: There are subtle differences between the ways the societal perspective is defined by PE guidelines in Europe and North America. This should be considered when devising evidence generation activities to support economic modelling, and may ultimately impact the outcome of HTA decisions.