OBJECTIVES: In most western countries it is a prerequisite before a new drug is approved into the reimbursement system that its cost-effectiveness has been demonstrated. The pricing authorities’ assessment of the cost-effectiveness is usually based on a health economic evaluation required from the applicant. In Finland these evaluations have been obligatory since 1998. The objective of this study is to assess the present quality of these economic evaluations. METHODS: This study is based on a random sample of 13 economic evaluations submitted with price applications in Finland in 2012. These evaluations were assessed using a structured questionnaire with 25 different items. The items assessed include e.g. the choice of comparator, the method of analysis, the structure of the model, the estimation costs and health effects and the assessment of uncertainty. RESULTS: Only two of the 13 evaluations were reliable enough for their results to be used as such in the pricing and reimbursement decision. In seven evaluations the results were of some use in the decision making. Among the reasons limiting their usefulness were that they contained uncertain assumptions, that some costs items were excluded from the analysis, and that the effectiveness of the treatments was based mainly on assumptions. Four economic evaluations could not be used in the decision making at all because the comparator was wrong, the effectiveness estimates were biased, or there was a lot of uncertainty attached to the key parameters (effectiveness, quality of life and costs). CONCLUSIONS: There is still much to be improved in the quality of the submitted economic evaluations. This need for improvements is highlighted by the fact that the era of prolonged austerity has made it all the more important that only drugs with an acceptable cost-effectiveness ratio are accepted into the reimbursement system.