OBJECTIVES: To compare the quality of the health economic material submitted to the Swedish Pharmaceutical Benefits Board and the Finnish Pharmaceuticals Pricing Board as part of the application for reimbursement for new pharmaceuticals. METHODS: The health economic evaluations were reviewed in each country against two checklists, marking each question Yes/No/Not Applicable. The checklists used were: 1) the respective national Guidelines transformed into yes or no questions; and 2) the QHES check list, a validated instrument, was also used to provide a common comparator. The central estimate of cost effectiveness was collected (cost per QALY) as well as whether the application was accepted or rejected in each country. RESULTS: The Swedish scores range from 0.24 to 0.87 and on the QHES from 0.09 to 1, with a mean quality of 0.61 and 0.67 respectively. The Finnish scores range from 0.58 to 0,96 and on the QHES from 0.28 to 0.84, with a mean quality of 0.76 and 0.62 respectively. The correlation between the respective national guidelines and the QHES scores is modest (approx. 0.7 both in Sweden and in Finland). This is mostly due to country specific criteria. There was a low observed correlation between quality score and acceptance in Sweden and also in Finland. Likewise, the correlation between cost per QALY and decision to accept/reject is low to medium. CONCLUSIONS: Health economic material as part of applications to reimbursement agencies varies widely in quality. There are differences even for the same product in the two countries. Secondly, due to the relatively small number of applications studied and the even fewer rejections, it is difficult to draw firm conclusions regarding the value the pricing authorities studied place on a QALY.