OBJECTIVES: Perianal fistula, a complication of Crohn’s disease, affects health-related quality of life (QOL). This study aimed to elucidate QOL in health states corresponding to different stages of perianal fistula associated with Crohn’s disease in Japan.

METHODS: This cross-sectional, observational, web-based questionnaire survey assessed the utility values (QOL scores) of eight health states by the time trade-off method in patients with Crohn’s disease and individuals without Crohn’s disease (non-patients) recruited from the Medilead Healthcare Panel. The health state descriptions developed in a previous study in the UK were translated into Japanese. In patients, we also determined the utility value of the current health state associated with Crohn’s disease. The age and sex distribution of non-patients was adjusted to match that of the general population in Japan. The analysis excluded respondents with inconsistent answers.

RESULTS: The analysis included 82 patients and 576 non-patients. In both groups, mean utility values were higher in remission (patients, 0.78; non-patients, 0.51) than in non-remission states, with lowest values for poor prognosis after proctectomy (patients, 0.13; non-patients, −0.10) and highest values for the state with mild symptoms (patients, 0.60; non-patients, 0.30). In patients, the mean utility value of the current health state was 0.71, and no differences were found between subgroups with different health states.

CONCLUSIONS: This study quantitatively measured QOL of eight health states based on severity and postoperative clinical course of perianal fistula associated with Crohn’s disease from the viewpoints of patients with Crohn’s disease and non-patients. The results indicate that the higher the severity of perianal fistula, the lower the utility value of corresponding health states. In addition, utility values are lower after proctostomy than in remission, even if the postoperative clinical course was good.