OBJECTIVES: Quality-adjusted life year (QALY) measures are important for assessing cost-effectiveness. Currently, the EQ-5D and SF-6D are the most commonly used QALY measures within cost-effectiveness analyses for spine pain. A number of studies have assessed the measurement properties of QALYs for spine pain, but mostly within surgical populations. Our objective was to estimate the test-retest reliability, construct validity, and responsiveness of commonly used QALY measures among older adults with chronic neck pain managed non-surgically. METHODS: Data was collected within a RCT comparing combinations of home exercise and advice, supervised exercise therapy, and spinal manipulation for chronic neck pain in older adults (≥65 years old). QALYs were measured with the SF-6D, EQ-5D-3L, and Euroqol visual analogue scale (EQ VAS) using U.S. population values. Test-retest reliability was determined using intraclass correlation coefficients (ICCs). Bland-Altman methods and the smallest detectable change (SDC) were used to assess agreement. Known-group validity and responsiveness were estimated using global change in health; global improvement in neck symptoms; neck pain; and neck disability as external criteria. The relative responsiveness of the QALY measures was estimated using correlation and area under the ROC curve. RESULTS: The SF-6D demonstrated better test-retest reliability (ICC = 0.81) relative to the EQ-5D (ICC = 0.44) and EQ VAS (ICC = 0.68), in addition to better longitudinal known-group validity. QALY measures demonstrated similar responsiveness with correlations between QALY measures and three of the external criteria negligible to low in strength (-0.233 to -0.391). Correlations with neck disability were low to moderate in strength with the SF-6D demonstrating the strongest association (-0.596). There were no significant differences in area under the ROC curve. CONCLUSIONS: There were minor differences between U.S. QALY measures in terms of responsiveness; however, the SF-6D was more reliable, demonstrated less measurement error, and better known-group validity relative to the EQ-5D-3L and EQ VAS.