Pharmacist-led medicines use review (MUR) and medicines reconciliation (MedRec) aim to identify, resolve and prevent patient-related drug-related problems (DRP) and medication discrepancies in order to optimize medicines use and ensure the patient safety. As “diagnostic-resolution” interventions, the question of their economic impact and cost-effectiveness from healthcare systems perspective is crucial, and the level of their related evidence could support or challenge the dissemination and sustainability of these interventions in health systems. This chapter addresses two main questions: how is the economic impact and cost-effectiveness of these interventions modelling in the literature? And what is the economic evidence for these interventions? This content derives from the identification and selection of full economic evaluations of MUR and MedRec and systematic reviews or meta-analyses for which the main outcome was to assess their economic impact. Despite the demonstration of their effectiveness in identifying and resolving safety issues (patient-related DRP and edication discrepancies), studies have struggled to demonstrate their clinical and economic impact, probably due to the poor quality and heterogeneity of the studies, as well as the debatable accuracy of the outcomes. Future research and high-quality studies are needed to address these issues.