PURPOSE: To present and discuss the issues surrounding the health economic evaluation of genomic technologies. This will be illustrated by evaluations of genomic technologies in both diagnostics and pharmacogenetics. DESCRIPTION: Genomic technologies are rapidly advancing and genomic testing is increasingly being discussed for use in clinical practice. However, internationally, adoption rates for innovative technologies vary considerably, which is partly due to a lack of economic evidence. Since technological innovations are known to be a major cost driver in health care, and health care expenditures are rapidly increasing, there is a growing need for health economic evaluation of genomic innovations such as whole-genome sequencing. However, certain specific problems arise in the health economic evaluation of genomic technologies. First, Kirsten van Nimwegen describes the issues in early HTA surrounding genomic diagnostics which might not result in QALY gains. Then, Geert Frederix shows an economic evaluation of whole-exome sequencing in complex paediatric neurology. Subsequently, Rene Sluiter presents a cost-utility analysis of genetic screening as a tool to individualize patient treatment trough medical selection or dose adjustment based on a patient’s genetic profile. Finally, Sarah Wordsworth will reflect on the issues encountered in the presented cases, and elaborate on which issues require special attention if the economic evaluation of genomic technologies is to be successful. Finally, there will be room for discussion in which the audience is encouraged to share their experiences and thoughts on health economic evaluation of genomic technologies.