IntroductionClinical practice guidelines are systematically developed statements to assist practitioner and patient decisions about appropriate healthcare for specific clinical circumstances. When adhered to, they have been shown to have the potential to improve both the process of care and patient health outcomes. Economic issues can be incorporated into guidelines with respect to both recommendations (based on the criteria of cost effectiveness) and defining outcomes for assessing adherence with guidelines.MethodsWe reviewed 217 Canadian clinical practice guidelines relating to prescription medications. The role of economics within existing practice guidelines was assessed using standardized abstracting techniques.ResultsCosts or economics were considered in only 26% of the guidelines identified. The role of economic considerations within these guidelines varied considerably from a relatively minor to major role. Furthermore, only 4% of guidelines defined measurable outcomes, including economic outcomes, that could be monitored to assess adherence with recommendations.ConclusionsThe inclusion of economic considerations in clinical guidelines in Canada is limited. The possible reasons for this lack of economic considerations need to be explored further. Without consideration of economic issues when developed, clinical practice guidelines may lead to a more inefficient healthcare system.