OBJECTIVES: To determine the cost-effectiveness of using an online questionnaire (ePAQ-PF) in combination with a telephone consultation compared to standard care.  METHODS: All women, aged ≥ 18 years and referred to urogynaecology services in Sheffield were eligible. Women completed ePAQ-PF online and then received a telephone consultation (intervention), or face-to-face consultation (standard care). Costs for ePAQ-PF completion and consultation were derived in a microcosting study. Resource use data were collected at 6-months follow-up. The SF-12 was administered at baseline and follow-up. SF-6D estimates were used to calculate quality-adjusted life-years (QALYs). Patient experience was measured by the Patient Experience Questionnaire and Client Satisfaction Questionnaire. RESULTS: 195 women were randomised. Consultation costs for the intervention group (£31.75) were lower than for the control (£72.17). The intervention group incurred greater direct costs and personal expenditure during follow-up. However lower costs associated with productivity loss for the intervention group resulted in lower indirect costs per-patient.  Mean total costs per-patient were £38.04 greater in the intervention group (£1,139.86) than the control (£1101.82).  SF-6D scores reduced slightly during follow-up for the intervention group, and increased slightly for the control, resulting in  QALY loss for the intervention group, and QALY gains for the control. Statistically significant gains in patient experience were identified for the intervention group, although in strict cost-utility terms the intervention was dominated by the control. Incremental costs and QALYs resulted in a negative incremental cost-effectiveness ratio (ICER). CONCLUSIONS: Although the intervention was not cost-effective compared to the controls, there was a significant difference in an important aspect of the care process, which was not captured by the ICER. This highlights the importance of decision makers accounting for intervention effects that fall outside the conventional conceptualization of the QALY.  Methods could be developed that allow non-health effects, such as process utility, to be incorporated into the QALY.