OBJECTIVES: Pharmacoeconomics (PE) has been defined as ‘the description and analysis of costs of drug therapy to healthcare systems and society'. PE concepts and methods have been with us since the early seventies. The trend in the use of PE in formulary decision-making, disease management programmes and cost-effectiveness of health-care interventions is on the increase. This study investigated the role of PE in decision-making in the private and public sectors of the healthcare system in the Gauteng region. METHODS: Two focus group sessions were conducted at Technikon Pretoria. Face-to-face interviews were also conducted with key informants in PE who did not participate in both focus groups. The triangulation method of combining focus group methods and face-to face interviews was chosen to increase the reliability of the data. Six and three participants for the first and second focus groups, respectively, with similar backgrounds in PE were recruited from both the private and public sectors. A moderator who was conversant in PE facilitated the focus group sessions while the researcher recorded the responses from the participants. RESULTS: Using the Donabedian matrix for the analysis, mixed results were observed in the private and public sectors about the perception and use of PE. There was an increased awareness of PE as a decision-making tool by most respondents. Lack of PE culture, conflict of interest, and wastage of resources were the most prevalent healthcare concerns affecting both sectors of the healthcare system of the Province. Although PE methods are globally transferable, models are required to reflect the Gauteng Province's healthcare setting. CONCLUSION: PE exists as a decision-making tool aimed at demonstrating the value for money in the allocation of healthcare resources. PE is instrumental in understanding and solving the healthcare issues faced by decision makers both sectors of the healthcare system in the Gauteng Province.