OBJECTIVES: Most cost-effectiveness analyses in epilepsy attempt to base quality of life (QOL) on seizure frequency. However, QOL in epilepsy is multi-factorial, including psychosocial factors that are best captured in a disease-specific patient reported outcome (PRO). This study uses QOL surveys from patients with epilepsy to derive utility weights from a validation study on the QOLIE-31 (Quality Of Life In Epilepsy), a commonly-used disease-specific PRO. METHODS: Three-thousand responses to the QOLIE-31 were simulated in a distribution identical to that found in the 1998 validation study for the PRO. Responses to the SF-12, a generic QOL inventory, were collected from 169 patients with epilepsy were collected from three consecutive years (2009-2011) of responses to the Medical Expenditure Panel Survey (MEPS), then converted into an SF-6D score from which utility weights can be derived using a validated formula. The simulated data points and SF-6D scores were distribution matched such that scores at the nth percentile on the QOLIE-31 map to the utility weight at the nth percentile within the distribution of utility weights.  RESULTS: The average patient with epilepsy with a mean score of 60 on the QOLIE-31 is predicted to have a utility weight of 0.709. QOLIE-31 scores of 28, 44, 76, and 94 (representing -2, -1, +1, and +2 SD) have utility weights of 0.422, 0.492, 0.851, and 0.926, respectively. CONCLUSIONS: Seizure frequency alone is a convenient, but imprecise measure of QOL for patients with epilepsy, since it does not account for the psychosocial difficulties that arise from the unpredictability of seizures. These impairments to QOL are best accounted for in a disease-specific PRO. This study's mapping of responses to the QOLIE-31 onto utility weights allow cost-effectiveness analyses to be built around the more holistic measure of QOL provided by a PRO validated for patients with epilepsy.