OBJECTIVES: To conduct a pilot study examining the validity and reliability of a paper-based standard gamble (PSG) instrument and to administer the validated PSG among persons with hemophilia B enrolled in the Hemophilia Utilization Group Study (HUGS-Vb). METHODS: Fifteen pharmacy students were enrolled in this pilot. We presented a hypothetical scenario describing a patient with severe hemophilia to each participant, followed by three tests: (1)Standard Gamble (SG) using the probability wheel, (2)PSG and (3)Visual Analog Scale (VAS), each administered in random order. PSG was re-administered after two weeks to assess test-retest reliability. The validated PSG was subsequently administered to participants enrolled in HUGS-Vb, a prospective, multicenter study collecting utilization and other data associated with hemophilia B in the United States. Participants or their parent(s) completed a demographic questionnaire, the PSG and the EQ-5D. A PSG scenario based on actual demographic and clinical characteristics was created for each participant. Paired t-test, Spearman rank correlation coefficient (rho) and intra-class correlation coefficient (ICC) were used to assess the convergent validity and reliability of the instrument. RESULTS: Mean SG, PSG and VAS in the pilot were 0.79±0.15, 0.82±0.14 and 66.8±23.0, respectively. The mean difference between PSG and SG did not differ significantly from 0 (p=0.124). PSG was significantly correlated with SG (rho=0.769, p=0.0008) and VAS (rho=0.534, p=0.0405). PSG retest score was 0.79±0.13 and test-retest ICC was 0.85 (95% CI: 0.63-0.94; p<0.0001). Of 71 HUGS-Vb participants, 32 (45%) were adults; 38 (54%) had severe hemophilia. Mean age was 21.8 years (range 2-61). Mean PSG and VAS scores were 0.91±0.15 and 84.4±14.6 respectively, with weak correlation between the two (rho=0.242, p=0.0452) in the full sample. Adult PSG and EQ-5D scores were 0.87±0.18 and 0.85±0.16 respectively, with correlation rho=0.348 (p=0.0506). CONCLUSIONS: A paper-based standard gamble instrument may be a valid, reliable alternative to SG for measuring health utility in hemophilia patients.