- Objectives: The study evaluated the extent to which quality-adjusted life-years (QALYs) and healthy-years equivalents (HYEs) were used in cost-utility studies over the past 20 years (1981-2000) as well as possible changes in the quality of journals reporting cost-utility studies. Methods: Cost-utility studies were identified through an electronic search. For each study the journal name, date of publication, article's language and research origin, and the journal's impact factor were recorded. Results: The number of published cost-utility studies increased in the last 20 years but has leveled off in 1997. Most studies were performed in the United States and were published in English. All studies except one used QALYs as an outcome measure. The mean journal's impact factor has changed slightly over the years. Conclusions: Cost-utility studies would possibly gain more popularity if they were used as a vehicle in the decision-making process regarding healthcare budgets and were more visible in the scientific literature.