OBJECTIVES: Greater market availability and high per unit costs make biopharmaceuticals one of the fastest growing areas of health care spending.  As a result, policymakers are increasingly questioning whether they provide value for money.  The purpose of this study was to examine the cost-utility literature to compare the value of biopharmaceuticals with conventional pharmaceutical and non-pharmaceutical interventions. METHODS: The Tufts Medical Center Cost-Effectiveness Analysis Registry (www.cearegistry.org), which contains detailed information on over 2300 cost-utility analyses (CUAs), was used for the analysis.  Articles for biopharmaceuticals were identified using the Biotechnology Database from the Tufts Center for the Study of Drug Development.   The characteristics and study quality of all articles published between 1976 and 2009 were compared across the three categories of interventions.  The distribution of cost-utility ratios, weighted by the number of published ratios in the article, for each intervention category and selected diseases studied were also compared.  RESULTS: Studies of biopharmaceuticals comprised 11% of the 2383 studies included in the Registry, making them the sixth largest category.  Overall characteristics of biopharmaceutical articles were similar to other CUAs, yet they had slightly better methodological quality.  The weighted median ratio for biopharmaceuticals ($15,412) was less favorable (i.e., higher) than those of conventional pharmaceuticals ($7,095) and most other types of health interventions ($9,284).  Ratios for biopharmaceutical cancer, rheumatologic, and neurological therapies were also significantly more likely to be greater than the overall median of $9041 as compared with other interventions.  Despite these results, the wide range of biopharmaceutical ratios suggests many nevertheless provide value for money. CONCLUSIONS: Biopharmaceuticals occupy a small yet increasing role in the cost-utility literature.  While, in aggregate, they are less favorable than most other types of treatments for a number of diseases, the data suggest that many individual biopharmaceutical therapies are cost-effective.