AIM To evaluate the effectiveness, safety and economy of lorlatinib in anaplastic lymphoma kinase (ALK) positive non-small cell lung cancer (NSCLC) patients, and provide evidence for clinical treatment. METHODS Databases such as PubMed, Cochrane Library, CNKI, Wanfang Data, and VIP and Health Technology Assessment (HTA) related websites were searched to collect HTA reports, systematic evaluation/meta-analysis and pharmacoeconomic evaluation of loratinib for ALK positive NSCLC. Select the literature according to the inclusion and exclusion criteria, extract the data, and evaluate the literature quality. Qualitative description was performed. RESULTS A total of 16 literatures were included, involving 11 systematic review/meta-analysis and 5 pharmacoeconomic evaluation. In terms of effectiveness，compared with other ALK-tyrosine kinase inhibitors (TKIs) and chemotherapy as first-line treatment, lorlatinib significantly prolonged the progression free survival (PFS) in ALK positive NSCLC patients. Compared with chemotherapy as a second- or third-line treatment, lorlatinib significantly prolonged PFS and overall survival. In terms of safety, there was no statistical difference among the ALK-TKIs and chemotherapy in the incidence of adverse events (AEs) of grade≥3, but the incidence of lorlatinib was relatively high. In regards to the serious AEs and AEs leading to treatment discontinuation, lorlatinib was the lowest. In terms of economy, lorlatinib was not cost-effectiveness compared to ensartinib and crizotinib in China, but lorlatinib was cost-effectiveness compared to chemotherapy as a second- or third-line treatment in Greece and Sweden. CONCLUSION Lorlatinib shows good efficacy and safety for ALK positive NSCLC, but its cost-effectiveness after price reduction in China needs further evaluation.