More than 10 years ago, the Australian government took the bold and unprecedented step of announcing that it would request evidence on comparative cost-effectiveness of new pharmaceutical products, assess this evidence, and then use it to guide systematically the decisions as to whether to subsidize these new products. This paper summarizes the Australian drug subsidy scheme and the activities involved in making this announcement work in practice, assesses the impact these activities have had on broader policy actions, and examines whether these have resulted in any worthwhile achievements.