OBJECTIVES: To assess patient reported health utility among patients with HR+/HER2- advanced/metastatic breast cancer (ABC/MBC) in a real world setting. METHODS: Patients with HR+/HER2- ABC/MBC in 5 major EU countries (N=613) and the US (N=126) were recruited into a multicenter study. Health utility was assessed using EQ-5D, a standardized measure of health status that consists of a descriptive system comprising 5 dimensions: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression rated at 3 levels (no, some, or extreme problems) and a single index score for health status calculated using country-specific algorithms. In addition, a visual analogue scale (VAS) measured self-rated health status from ‘0’ (worst imaginable) to ‘100’ (best imaginable). Scores were stratified by sites of metastases and line of therapy, and compared using Kruskal-Wallis tests. RESULTS: Patients had mean (SD) age of 65.2 (10.6). Majority of patients (83%) had MBC. Mean (SD) EQ-5D index score was 0.73 (0.29) and mean (SD) general health status score was 61.9 (20.7). Patients with both bone and visceral metastases had the lowest (mean [SD]) EQ-5D index score (0.62 [0.34]) compared to those with bone (no visceral) disease (0.69 [0.33]) and visceral (no bone) disease (0.78 [0.26]), p<0.0001. Patients on 1^st line therapy had the highest EQ-5D index score (0.77 [0.26]) compared to those on 2^nd (0.69 [0.33]) and 3^rd lines or later (0.69 [0.28]), P=0.0001. No statistically significant differences were observed in the general health status score between lines of therapy or between sites of metastases. CONCLUSIONS:  Sites of metastases and lines of therapy have a significant impact on EQ-5D index scores with patients with both bone and visceral metastases and those receiving later lines of therapy reporting significantly worse scores.