OBJECTIVES: The lack of empirical and well-accepted cost-effectiveness (CE) threshold is recognized as one of the most important barriers in using Health technology assessment (HTA) in policy decisions and this is no exception in Asia Pacific region. HTAsiaLink, a network of HTA organizations in Asia has embarked on first collaborative research on determining the CE threshold across 4 countries in Asia Pacific region namely Korea, Japan, Malaysia, and Thailand. This pilot study aimed 1)to explore the feasibility of the instrument/methods used 2)to examine the value of a quality-adjusted life-year (QALY) associated with improving quality of life in mild, moderate and severe health condition, and extending life during terminal illness. METHODS: Five EQ-5D health states with different health severity (11121, 11212, 11323, 11223 and 22332) were used. For improving quality of life scenarios, willingness-to-pay (WTP) to avoid being in the given health state for a given duration was determined to ensure the similar magnitude of QALY gained (0.2 and 0.4QALYs) across health conditions. Similarly, in extending life during terminal illness and life saving scenarios, WTP for increasing life expectancy for given 0.2 and 0.4QALYs were examined. Data were analysed using Predictive Analytics Software (PASW v18.0). RESULTS: The mean WTP/QALY value for 199 adult was estimated at MYR10,505 (SD:17311) for mild, MYR10,906 (SD:15,101) for moderate and MYR14,981 (SD:21,774) for severe health condition. For terminal illness with extended life scenario, it was estimated at MYR19,611 (SD:27,054). Participants took mean of 29.74 minutes (SD:6.77) to response. One-third (32.2%) of the respondents felt the questionnaire was difficult to answer and 7% rated it as very difficult. CONCLUSIONS: The instrument used was feasible for determining the value of WTP/QALY. However, further revision of the questionnaire may be required to simplify the research task. This study also suggested that the threshold for Malaysia to be MYR10,505(0.35GDP)–MYR19,611(0.66GDP) per QALY.