To facilitate decision making the Department of Health commissioned a systematic review of all published economic evaluations (not just UK studies) with a view to constructing an economic evaluation database.1 This systematic approach has been influenced by the Cochrane style systematic review process of clinical evaluations and is a progression from the widely publicised “QALY league table” approach. A QALY (quality adjusted life year) league table ranks interventions according to the extra cost per extra quality adjusted life year gained. Ideally this approach should help direct health care resources to those interventions which produce the most QALYs for the least cost. However, economic data are often specific to time and place, and extrapolation of economic results between localities and especially between countries should be treated …