OBJECTIVE: Do people weigh gains in life years differently when patients differ in age (but not in life expectancy), life expectancy (but not in age) or QOL (but not age or life expectancy)? METHODS: Trade off questions wer developed searching for indifference between giving healthy life years to patients with different ages, prognoses and quality of life. Data come from 46 heart failure patients, 60 healthy controls and 180 students. For age, as well as prognosis and QOL, six comparative sets were developed. Each respondent answered two questions of each set and two combination-questions. Ordered logistic regression was used in combination with conditional linear regression for “extreme” answers. Answers are “extreme” when, for example, one extra life year in a young patient is preferred to 10 in an old patient or when respondents can't choose. RESULTS: More than 40% of the answers are “extreme”. Respondent prefer to give to the young and to those who are worse off, either now (quality of life), or in the future (prognosis). Elderly individuals, more often, prefer not to prioritize. It is estimated that an additional life year in a 20 year old is worth 12.8 times the value of an additional year in an 80 year old. An additional life year given to someone with a life expectancy of five years is worth 2.12 times that of one given to someone with a life expectancy of 10 years. An additional life year in someone with a utility that is 0.25 lower than someone else it is worth 2.45 times more. CONCLUSIONS: All results indicate that people do not think that a QALY is a QALY and that the value of life years depends on the age of the respondent, the prognoses of the patients and the patients' current quality of life.