Reflects the time preference for benefits earlier rather than later; it also reflects the opportunity costs of capital, i.e., whatever returns on investment that could have been gained if resources had been invested elsewhere. Thus, costs and outcomes should be __ relative to their present value allows comparisons involving costs and benefits that flow differently over time. It is less relevant for “pay-as-you-go” benefits, such as if all costs and benefits are realized together within the same year typically based on interest rates of government bonds or the market interest rates for the cost of capital whose maturity is about the same as the duration of the effective time horizon of the health care intervention being evaluated.