OBJECTIVES:  The objective of this study was to examine the extent to which medical specialty societies have integrated economic evidence into their clinical guidance documents, with a particular focus on (a) whether and how the patient perspective on cost was taken, and (b) whether and how physicans were guided on how to discuss economic considerations alongside safety and efficacy parameters. METHODS: We reviewed recently issued clinical guidelines from over 20 leading medical organizations across a variety of therapeutic areas. For each guideline, we considered if and how economic data were presented in the guideline, and summarized how the medical organization recommended incorporating economic decisions into clinical decision-making. We also examined whether the guidelines made recommendations regarding the consideration of patient perspectives on economic value of potential treatments. RESULTS: The majority of guidelines reviewed made some recommendation regarding the assessment of value. The nature and strength of the recommendations varied widely. Some organizations simply made generalized statements about the importance of considering value, while others were explicit in their recommendations regarding cost per quality adjusted life year assessments.  None of the guidelines considered discussed the patient perspective on economic value, and none offered explicit guidance on how clinicians should approach a conversation with patients about economic value. CONCLUSIONS: Our review demonstrates that efforts to incorporate economic data to support clinical decision-making are still in its early stages. A number of societies consider basic cost or burden elements as part of topic selection or recommendation formulation. None of the reviewed societies have systemically incorporated economic assessment in a manner that would enable the physician and the patient to jointly make an informed decision based on value. Researchers have a clear role to play in helping guideline developers incorporate the patient perspective in discussions of cost/cost-effectiveness, and helping physicians develop tools to communicate value.