Clinical pharmacologists have three distinct contributions to make in the economic evaluation of new and existing pharmaceutical products: they should play a significant role in promoting the principles of "opportunity costs" in healthcare; they need to have a broad understanding of the methodology of economic evaluation in healthcare; they have a critical role in bringing their specialist knowledge, skills and experience in decision-making. In fulfilling these essential roles clinical pharmacologists may find themselves outside their conventional "comfort zones". Nevertheless, clinical pharmacologists need to rise to the occasion if they are to meet their obligations to patients and to society as a whole.