The China Guideline for Pharmacoeconomic Evaluations was published in April 2011 and subsequently released on the official website of ISPOR. It is the most authoritative pharmacoeconomic (PE) recommendation in China, which provides a solid foundation for economic evaluations in China. In recent years, PE has been used by various central and state ministries and agencies to assist decision makings in the healthcare management and reform in China. For instance, the idea and method of PE were essential considerations in both the update of national reimbursement drug list (NRDL) and the negotiation of innovative drugs in 2017. Moreover, developing PE research is challenging and its application is far from being expected. It is due to the shortage of publicly accessible clinical data to support high quality study, absence of comprehensive, standard, sustainable and primary epidemiological database, lack of data matching or exchange between different ministries and hospitals, and inadequate government research grant to support unbiased research. According to the international experiences and China realities, the first recommendation is to enact an “official” guideline that are recognized and required by the government in China. The second recommendation is to establish a PE research agency with certification authority by the Chinese government to ensure the impartiality and reliability of economic evaluations. The third recommendation is to update the guideline on a regular basis together with improving clinical and epidemiological database as well as developing more fundamental studies such as quality of life. The fourth recommendation is to strengthen the PE talent pipeline. It is strongly believed that PE will play an increasingly important role in China in the field of R&D, pricing, essential drug list review, NRDL review, healthcare policy making and rational use of drugs in the near future.