The original Panel recommended a societal Reference Case as a point of comparison across studies. The Second Panel reconsidered at length the perspectives that Reference Case analyses should use. Many, if not most published cost-effectiveness analyses (CEAs) have not used a true societal perspective. Further, decision-making bodies that have incorporated CEA into health technology assessment to inform coverage and reimbursement decisions have not adopted a societal perspective. Given this backdrop and various options, the Second Panel recommends that all studies report two Reference Case analyses: one based on a healthcare sector perspective and one based on a societal perspective. We recommend that analysts present all items in an analysis as disaggregated consequences in an Impact Inventory to ensure that all consequences, including those outside the formal healthcare sector, are considered regularly and comprehensively, as they have generally not been to date.