OBJECTIVES: The study tests the hypothesis that physicians and patients value "quality-of-life" benefits more highly than managed care decision makers. In conducting this test, we focus on the treatment of migraine headaches, a therapeutic area for which current drugs exhibit a wide range of costs and benefits. METHODS: To test the hypothesis, we conducted surveys and conjoint exercises with physicians (N=10), patients (N=26) and MCO formulary managers (N=5). Conjoint analysis is a survey-based technique for objectively measuring willingness to trade off different product (or service) attributes. RESULTS: We found that both patients and their physicians are willing to spend four to five times more than MCO formulary managers for a migraine treatment that has a good chance of relieving pain within 15 minutes, allowing quick return to normal activities. We also found that patients and physicians are willing to pay much more than MCO formulary managers for other quality-of-life benefits, including preferred dosage form, nausea relief and avoiding drowsiness. CONCLUSIONS: The results support our hypothesis that physicians and patients value quality-of-life benefits more highly than MCO formulary managers. However, the sample sizes involved are too small to permit strong inference.