Introduction: There is an increasing interest in nanotechnology-enabled drug delivery systems which are expected to have significant impacts for health care. The economic and societal aspects are uncertain, even ambiguous, at this stage of development, and often not addressed, or only as part of the promises about present options. Areas covered: In our review we will report on assessments of actors regarding economic and societal aspects and, occasionally, of expected impacts. Topics discussed include: present and future markets of nano-enabled drug delivery, industry dynamics, regulation, cost-effectiveness, and broader ethical issues. We also include a brief discussion of anticipatory activities of actors who are concerned about these aspects. Expert opinion: Performance of nano-enabled drug delivery, a necessary step to have future impacts at all, needs to be improved further, and in interaction with demands of users along the product value chain and with further stakeholder such as regulatory agencies and health insurers. When supported by analysis of societal embedding of new products and scenarios, this allows relevant societal and economic aspects to be taken into account at an early stage. A key issue in realizing impacts will be liability, and roles and responsibilities of technology developers and stakeholders more generally.