OBJECTIVES: The special committee of cost-effectiveness at the Japanese health ministry advisory panel was established in 2012 and the need for economic evaluation guidelines was proposed. The research team funded by the Japanese Ministry of Health, Labour and Welfare published the guidelines for economic evaluation of healthcare technologies in 2013. We compared the Japanese guidelines to existing guidelines in other Asian countries and to the NICE guidelines (United Kingdom). METHODS: We searched for and reviewed the Japanese research report and guidelines published in China, Taiwan, Thailand and South Korea up to February 2014. Similarities and differences between Japanese guidelines and those from other Asian countries as well as NICE guidelines were identified. RESULTS: Pharmacoeconomic evaluations are mandatory in the UK, South Korea and Thailand, recommended in Taiwan, and optional in China. In Japan, economic evaluations are currently not formally considered in pricing and reimbursement decisions. Japanese guidelines are relatively open, leaving much room for decision from analysts. Guidelines from different countries were broadly consistent in terms of preferred analytical technique (cost-effectiveness analysis), need of systematic reviews of evidence and consideration of effectiveness data as well as efficacy; but varied in terms of primary perspective for estimating costs (third-party payer in Japan), preferred outcome measure (no systematic use of QALYs in Japan, other measures, such as laboratory values, also accepted), preferred methods to derive utility values (generic instruments with scoring algorithm developed in Japan), and sensitivity analysis methods (probabilistic sensitivity analysis “when possible”). CONCLUSIONS: This comparative exercise provides an overview of economic evaluation guidelines adopted by 5 Asian countries and UK. The recommendations differed in some aspects, but Japanese guidelines are relatively open, which should facilitate adaptations of models between countries. One of the hurdles for adapting models is likely to be the variability in approaches recommended to obtain utilities.