In this issue, Berggren et al. [1] provide a useful comparative summary of 25 current pharmacoeconomic guidelines from Europe, North America, and Australia. One can look at these guidelines as reflecting major progress since Australia first promulgated formal methodological standards for economic evaluation of pharmaceuticals in 1992. Berggren et al. [1] find that there is substantial consensus on many issues of methodology, including target audience, preferred outcome measurement, type of analysis, treatment comparators, acceptable data sources, use of modeling, time horizon, sensitivity analysis, and results reporting. Pharmacoeconomics has come of age in being able to point to a body of generally accepted methods, techniques, and practices. This is certainly good news.

The areas with less harmonization include choice of study perspective, resources and costs to be included in the analysis (particularly the treatment of informal costs), and method of pricing resources used. It isn’t surprising that type and price of resources evaluated would exhibit discordance, since most differences here flow directly from differences in the study perspective chosen. Most of the guidelines acknowledge the value of a societal perspective for pharmacoeconomic analyses, but some guidelines require a narrower health plan or government perspective, rather than a societal one.