ISSUE: Is the QALY the most appropriate single-dimensional measure of health for decision making? OVERVIEW: Weinstein highlighted many years ago the potential issues with the QALY (Weinstein 1988, A QALY is a QALY - is it?). However, it remains a key determinant in HTA deliberations, with countries like Australia (PBAC), Canada (CADTH) and England (NICE) primarily basing their funding decisions on incremental costs per QALY gained. Deciding to reimburse drugs based on health technology assessment is complex due to a number of factors such as budgetary constraints, political pressure and vocal advocacy groups. Whether or not the QALY is the most appropriate single-dimensional measure of health for decision making is not always clear. This session will discuss how QALYs relate to HTA in 2018, as well as alternative metrics. The speakers will represent three different perspectives. First, Professor Sculpher will give a brief description of how QALYs are used in a reimbursement framework and why it is an essential component of consistent decision making. Then Professor Caro will discuss the viability of the QALY-based approach and argue that its use is not essential for economic evaluation. Finally, Professor Liew will discuss alternative metrics.