OBJECTIVES: To survey expert opinion on trends in economic evaluation by UK pharmaceutical and medical device firms, from R&D to product launch and beyond. The background is the move in some EU countries, exemplified by NICE in UK, towards emulating the Australian “fourth hurdle” of mandatory economic data requirements before pharmaceutical purchasing. METHODS: Interviews with a range of experts from UK industry and academia. Industry representatives included both science experts and policy experts from six pharmaceutical firms and four medical device firms; academics included both health economists and pharmaceutical policy specialists. RESULTS: Dramatic increase over the last decade in production of pharmacoeconomic evidence at late development and early marketing stages in response to more aggressive management of pharmaceutical budgets. Medical device firms lag behind, due to smaller size and less aggressive purchasers, but large firms are now starting to design trials with economic evaluation in mind. Limited improvement in scientific quality of pharmacoeconomic evidence in relation to state-of-the-art methodology (“Washington Guidelines”); limited use of effectiveness trials, utility indices, cost-utility analysis, sensitivity analysis. Limited use of prospective cost-effectiveness modeling in R&D go/no go decisions, even though prospective modelling of return on investment is routinely used from early development onwards. Some industry representatives argue that pharmacoeconomics cannot be used to prioritize R&D since “hard” data are not available and uncertainties are great. Some academic economists disagree, however, arguing that prospective economic modelling is better than informal opinion. CONCLUSIONS: This study raises doubts about whether pharmacoeconomics has yet had much impact on R&D prioritization. If pharmacoeconomics is to succeed in guiding firms towards developing cost effective new products (i.e. ones delivering greater population health gains per unit of cost than existing products), then firms may need stronger incentives to use prospective cost-effectiveness modeling in R&D decisions.