OBJECTIVES: The objective of the present study was to evaluate whether people do include the effects of ill-health on income and leisure in quality of life valuation when the measure is silent on both. METHODS: A convenience sample of 20 health professionals (5 medical doctors, 2 medical researchers, and 13 nurses) were administered a questionnaire that described the health status of a 30-year old male patient suffering from multiple sclerosis (MS). Respondents rated that health status on a visual analogue scale (VAS) and were thereafter asked whether the impact of ill-health on income and leisure was included in their valuation. In case either answer was negative, they were explicitly asked to consider these effects in a second VAS question. RESULTS: Twelve (60%) respondents did not consider the effects of ill-health on income whereas only 5 (25%) respondents did not consider the effects of ill-health on leisure. The mean VAS score was significantly higher among respondents who did not consider income (48.33 versus 31.25, p = 0.036). Among those who did not considered leisure or income in the first VAS question, the mean VAS of the second question was significantly lower (mean difference 7.89, p = 0.005). However, five respondents (25%) who did not consider income in the first VAS question did not change their VAS score in the second question. CONCLUSIONS: The majority of respondents did not consider the effects of ill-health on income but on leisure. Moreover, respondents may not include the effects of ill-health on income even when they are explicitly asked to do so. Our results are in line with the argument that productivity costs related to paid work should be included as costs whereas productivity costs related to leisure time should be captured in the QALY. Still, health state valuations may need to be more explicit in this respect.