Background:Cancer is one of the most prevalent diseases in the UK with over 300,000 cases every year, with breast cancer being the most common cause of death for adults aged 35-64. 48% of all diagnosed with cancer die within 5 years. Cancer puts huge cost pressure on NHS resources. Multi-staged drug therapies involve the use of drugs to either slow down the proliferation of cancer cells or kill them, with variable success. The new innovative drugs are deemed to be too expensive for the limited benefit they may offer as the cancer may have reached terminal stage, after an already expensive overall course of therapy. OBJECTIVES: to perform a systematic review and meta-analysis to investigate whether the drug cost is the main driver for the high Incremental Cost utility ratios. METHODS:   Systematic review and meta-analysis were performed to answer the research question. The search was concentrated to the drugs of the three most common cancers in the UK (breast, lung and prostate). Cardiff search database was used to perform the search. Two independent reviewers screened papers for inclusion, extracted data, and assessed the quality of reviews. PRISMA checklist was used by the author to undertake the meta-analysis. RESULTS: CONCLUSIONS: Cost of drug treatments is not the main driver for the high ICER (P-value: 0.982) but it is one of many that heavily impact the ICER value.