OBJECTIVES: A budget impact analysis(BIA) is a useful tool for a healthcare decision maker in estimating the financial impact of the new technology. In Korea, the content and presentation of results of the BIA have been proposed but detailed guidance on methods for BIA are not yet available. To evaluate the international landscape of BIA guidance, we compared guidelines of BIA outside of Korea. METHODS: A literature review was performed. Research for guidelines was based on data published in latest official papers or reports from ISPOR and national institutes in Canada, Ireland, and Poland. RESULTS: In all guidelines, the recommended perspective was that of public purchaser. A time horizon of 2-5 years was considered to be desirable. It was stated that data on a technology and its use should be included in BIA, which is helpful for decision makers. Published guidelines provided a similar description of target population, but it was different whether or not off-label usage of drugs was included in assumption of population size. The approaches to measurement and evaluation of costs varied in different regions. The costing included direct costs associated with the technology in four guidelines but items of other costs were specified differently. When analysts report the results of study, both total and incremental budget impact should be presented for each year of the time horizon. Sensitivity analysis was emphasized in order to identify the uncertainty within the analytic framework. The guidelines suggested that the discounting is unnecessary and encourage model validation except those of Poland. CONCLUSIONS: This review discovered that Canada, Ireland, Poland, and ISPOR BIA guidelines were consistent in basic analytic framework, but details were depended on payer perspective and regional specificity. This study is expected to help to develop Korean BIA guidelines.