It is healthy for this initiative—any initiative—to receive peer input, and we appreciate the opportunity to reflect on the science and progress surrounding the EQ Health and Wellbeing (EQ-HWB). Much of the concerns raised by Perfetto et al¹ rest on the challenge of adequately involving patients in the development of instruments for a generic measure when there is no single patient group that should be privileged. The EQ-HWB aims to cover core aspects of health and wellbeing affected by health conditions and health interventions (including public health interventions), social care, and informal caring roles—a bold aim that by its very nature will not cover all that matters to potential future users of the instrument.