OBJECTIVES: Cancer is the second leading cause of mortality in the US. Treatment of cancer imposes an enormous economic burden on US private payers. Private payer medical policies are developed using published clinical evidence. The systematic reviews (SR) are considered as the highest quality evidence and are used to inform the clinical guideline and medical policies. Cochrane collaboration develops SR to inform healthcare decisions making. This study assesses the influence of Cochrane SR on the private payers’ medical policies of the drugs used for the treatment of cancer.  METHODS: The publically available medical policy documents of the drugs used for the treatment of cancer were scanned for the top four private insurers from the US, which together cover half of the US market, namely: UnitedHealthcare (UHG), Anthem, Aetna, and Cigna. The Cochrane SR used to inform these policy documents were identified by hand-searching. The relevant information such as the use of Cochrane SR, number of SR used, context of use of SR, impact of SR on policy, Cochrane review group and center to which SR belongs, and other data were extracted from each of the policy document.   RESULTS: A total of 39 SR were used to inform 54 policy documents of the oncology therapies. Less than a quarter (22%) of policy documents of oncology drugs of US private payers has used SR. Overall, for policies where SR was used, 21% of SR supported the clinical usage of the drug and imparted high impact on 33% of policies. A maximum 39% of Aetna’s and minimum 13% of the Anthem’s, oncology drug medical policies used SR as evidence while Cigna and UHG have not used SR as supporting evidence for oncology drugs. CONCLUSIONS:  Cochrane SR used to inform oncology therapy was quite a low. Scope persists to improve the usage of Cochrane SR to inform the payer policies of oncology drugs.