OBJECTIVES: To study self-estimates of rheumatoid arthritis (RA) patients regarding their future health related quality of life and to assess the acceptability of different health problems at certain stages of life. METHODS: A cross-sectional survey was performed in 12 rheumatology centres. RA patients initiating first biological therapy were involved. Disease activity (DAS28) was registered, health status (EQ-5D) and functional disability (HAQ-DI) questionnaires were applied. Participants were asked to indicate the health status they expect in 3 months time and for ages 60, 70 and 80 years, using the health problem descriptions of the EQ-5D. Concerns regarding ”some” and ”severe problems” in the dimensions of the EQ-5D and HAQ-DI were surveyed by age (acceptable from age 30, 40, 50, 60, 70, 80 or never). RESULTS: Altogether 116 patients (87.4% females) were involved, mean (SD): age 52.3 (11.7) years, disease duration 9.3 (8.3) years, DAS28 6.17 (0.89), EQ-5D score 0.348 (0.358), HAQ-DI 1.476 (0.653). Expected status after 3 months: EQ-5D 0.759 (0.270), HAQ-DI 0.648 (0.593). Patient expect to have significantly worse EQ-5D scores at ages 60, 70 and 80 than the actual age specific general population has, mean (SD): 0.438 (0.373) versus 0.728 (0.012); 0.240 (0.406) versus 0.682 (0.016) and 0.070 (0.411) versus 0.615 (0.024), respectively. The majority (26.3%-39.5%) pointed that ”some problems” in five dimensions of the EQ-5D are acceptable from age 70. The ”severe problems” level was rejected as never acceptable (54.3%-68.0%) except the ”usual activities” dimension wherat extreme problems were accepted from age ≥80 by 47.1%. Similar outcomes were found with the HAQ-DI. CONCLUSIONS: RA patients initiating biological drug expect quick improvement but prognosticate sharp health deterioration with age. Nevertheless, moderate health problems are considered as acceptable in advanced ages. These findings intend to support compliance research and health gain valuations.