This chapter shows a historical description of approaches to economic evaluation in SLE, both at national and international framework and highlighting the main elements that must be considered in clinical practice and decisions to avoid increasing the economic burden of health care.A non-systematic review of all published literature in English, French and Spanish from 1990 to April 2011 was performed using Medline, Pubmed, Cochrane, Lilacs and Scielo in peer-reviewed articles, including the Mesh-terms of systemic lupus erythematosus, direct costs, indirect and intangible cost, economic impact, disease burden, Cost-of-illness (COI) studies, pharmacoeconomics analysis, cost-effectiveness and costutility.It will have three types of approaches: the economic impact of the disease, COI studies and finally, a complete pharmacoeconomic assessment. OverviewAs previously mentioned, the economic evaluations on autoimmune diseases are lack and most of them have been carried out on Rheumatoid Arthritis (RA).In the case of SLE has virtually been restricted to studies of disease burden and cost-of-illness (COI).The COI studies measures the monetary burden that disease entails on society caused by morbidity and premature mortality in terms of consumption of health resources and lost of productivity.In 1967, Rice was the first to outline a methodological framework for calculating single-year cost of illness, disability, and death by major category of illness (2).In 1982, Hodgson and Meiners created the first guide to study COI (3).The studies' results are crucial to provide informative data to emphasize the extent of the disease problem and highlight the profile of patients with SLE.They also have the potential to serve as the basis to a major component in economic evaluations such as COI.A valuable COI study included direct, indirect, and intangible cost associated with the disease.Direct costs represent the opportunity costs of all kind of resources used to treat a disease (3).They usually include direct medical costs and direct non-medical costs.The first refer to the costs involved to provide treatment, including costs associated with the diagnosis, treatment, monitoring, emergency and rehabilitation, while non-medical costs refer to those which patients and their families spend on disease but are not medical in nature, including transportation costs, cost for household expenditures, and informal care.Indirect costs represent lost productivity associated with morbidity, which may be related to work or non-work activities.Indirect costs usually represent a large proportion of total costs in most of the COI.Indirect costs are usually measured by two methods: Human Capital Approach (HCA) and Friction Cost Method (FCT).The results obtained with one and another are not comparable and the first estimates tend to be lower than the second.The HCA estimates the indirect costs associated with illness and premature death in terms of lost productivity (lost wages), thus excluding the costs of pain and suffering, leisure time and work on a voluntary.The FCT, which considers the amount people would pay to reduce their risk of injury, illness or death, this is subjective and can be difficult to use in children and the elderly, due to the complexity of the questions (4).Intangible costs refer to patients' psychological pain of, discomfort, anxiety, depression, and stress related to disease or its treatment (5).These are difficult to quantify in monetary terms, therefore, they are usually omitted in COI studies or presented as quality of life.www.intechopen.