OBJECTIVES: Quality-adjusted life years (QALYs) are commonly used in health technology appraisals, including those by NICE in the UK. However, QALYs only include ‘health-related’ quality of life (QOL) which may not apply to interventions that have benefits and costs that fall outside of the NHS. NICE recommends that public health economic evaluations take a cost consequence or cost benefit approach and present a public sector or societal perspective. However, it is not clear how or if the costs and benefits that fall outside the NHS should be incorporated into this threshold for cost-effectiveness. The objective of this research was to investigate the methodology used in public health modelling, to determine the effect that this has on predicted cost-effectiveness and to make recommendations about the most appropriate methods to use. METHODS: We reviewed past NICE public health guidance and the associated economic evaluations to assess if methods tended to be based on the ICER alone or if other benefits are taken into account. In those instances where non-health benefits are included, we evaluated how this was done and if it was done consistently. RESULTS: Results showed that a range of methodologies were used to evaluate public health interventions in the UK and that the methods used were inconsistent. ICERs were often calculated despite not always being the most appropriate measure. There tended to be considerable uncertainty around data inputs in the majority of economic evaluations. CONCLUSIONS: The methods used to evaluate public health interventions in the UK vary, mostly by the type of economic evaluation and the perspective taken. ICERs were not always the most appropriate outcome. Variations in the methods could result in inconsistent recommendations across Public Health Guidance.