Two key questions in the context of UK health policy are: do the published preference indices for EQ-5D reflect the impact of lost earnings? Are we currently implicitly including indirect costs in our analyses? It is crucial to investigate whether or not individuals take into account any possible impact of lost income in health state valuation exercises. If respondents do consider income effects, and these considerations change valuations, then these effects would need to be excluded both under the current NICE reference case, or where productivity costs are included in the numerator to avoid double counting. This study adapts the study design used to generate population value sets for EQ-5D, as first used in the Measurement and Valuation of Health (MVH) Study, and carries out valuations of hypothetical EQ-5D states using Time Trade Off (TTO) exercises through an online survey administered in the Netherlands. Furthermore, this study uses a number of different TTO questions to explore the impact of losses in income on the valuation of hypothetical health states, and to determine the relationship between income and health.