BackgroundProgress towards universal health coverage requires evidence based policy and good quality cost data systems. Establishing these systems, can be complex, resource intensive and take time. Synthesising information on the experiences of low-and-middle income countries (LMICs) in trying to institutionalize cost data systems provides lessons for other settings.MethodsWe performed a scoping literature review, screening for publicly available peer-reviewed English-language publications alongside a grey literature search, focussing on national level health system costing in LMICs, and used a narrative synthesis approach to document experience of costing and how costing evidence is used to inform tariffs.ResultsA total of 484 papers were initially identified of which 30 papers were considered eligible. Fourteen papers reported on primary cost data collection for price-setting purposes; 18 papers provided an explanation of how cost evidence informs tariff-setting. Documented experience is largely focussed in the Asia region (n = 22) with countries at different stages of developing cost systems to inform tariff setting. Country experiences on healthcare cost accounting tend to showcase country costing experiences, methods and implementation. There is little documentation of how cost data has been incorporated into decision making and price setting. Where cost data, cost systems and costing has been used, improved transparency in decision making alongside increased service provision efficiency has followed.ConclusionsWhile there are accepted and widely used methods for generating cost information, countries need to build sustainable cost systems appropriate to their settings and budgets and adopt transparent processes and methodologies for translating costs into prices.