In this paper the first theme is the experience with the routine use of cost-effectiveness analysis in decisions by the Australian Pharmaceutical Benefits Advisory Committee on whether drug products should attract a government subsidy. As a second theme, the contrasting experience with several other health technologies is presented, with economic analysis being less frequently used in a system where there is a weaker regulatory framework. Some general points that emerge in both areas are the importance of factors other than economic evaluation in the decision-making process, and the need to make policy and administrative decisions on the basis of limited data. There is limited material available in the public domain on the interaction of economic evaluation and Australian policy on health technologies. It has been necessary, particularly in relation to the case studies presented here, to rely on input from discussion with a number of individuals and on observations made during personal involvement with some of the assessments. It is not possible to offer substantive evidence in support of this material, and indeed firm evidence in the area of impact of assessments on health policy remains difficult to collect.