OBJECTIVES: Targeted therapies (e.g. trastuzumab, cetuximab) are often said to constitute a new era of medicine. The new agents promise to be more effective and less toxic than standard care. The consequences on costs are still a matter of debate. While proponents refer to the enormous cost saving potential due to the avoidance of side effects or hospitalizations for example, opponents expect a massive increase in costs of care. However, the impact of targeted therapies on cost as well as their benefits are not yet clear. This review assesses the cost-effectiveness of targeted therapies. METHODS: We searched Medline, the Cochrane Library, Scopus, ISI Web of Knowledge and ScienceDirect for relevant articles published between 2001 and 2013. Internet search and scanning reference lists complemented our search. Authors independently reviewed titles, assessed articles’ eligibility for inclusion, determined methodological quality and extracted relevant data. RESULTS: In total 487 studies were identified. 50 of them met the inclusion criteria. 39 studies target either trastuzumab, or one of the aromatase inhibitors anastrozole, letrozole or exemestane. Quality of the studies was assessed using the checklist provided by Drummond/Jefferson (1996). The majority of the studies scored 80% or higher. With few exceptions studies are based on Markov models. Effectiveness as well as cost data were mostly obtained from clinical trials or literature respectively. Stated cost-effectiveness ratios ranged from 4.370€/QALY to 220.658€/QALY, whereas the majority of studies report favorable incremental cost-effectiveness ratios (≤50.000€/QALY). Models often did not incorporate the respective companion test adequately. Almost all studies were funded by the pharmaceutical industry. Studies without financial support report higher cost-effectiveness ratios. CONCLUSIONS: Results of the review indicate that targeted therapies seem to be cost-effective compared to standard care. As most of the studies have been funded by pharmaceutical companies, authors suggest that results must be interpreted with care.