OBJECTIVES: To determine, in a cross-sectional study, the relationship between active joint count (tender and swollen joints; TSJ) and health related utility (HRU) in Australian adults with rheumatoid arthritis (RA). METHODS: Consecutive subjects with RA attending routine clinical appointments were recruited regardless of disease severity, duration, current or previous treatment(s), or whether they qualify for reimbursed bDMARDs in Australia. Each patient completed a questionnaire comprised of general demographic and disease questions, the HAQ, HUI-3 and EQ5D. Each patient was asked to value their current health state. Each subject’s rheumatologist completed a second questionnaire on key clinical data pertinent to RA, including TSJ. The patient and physician questionnaires were completed on the same day. RESULTS: Subjects (N=170) with a broad spectrum of disease were recruited from four tertiary rheumatology referral centres. All subjects completed the study. A total of 38.2% of subjects were currently prescribed bDMARDs. Mean (SD) HUI-3 and EQ5D utility weights were comparable: 0.59 (0.28) and 0.64 (0.27) respectively. Although there was a statistically significant relationship between TSJ and HUI-3 (P=0.006), the correlation for the corresponding linear regression was weak (R2=0.044). The relationship between TSJ and EQ5D was weak and not statistically significant (R2=0.028, P=0.99). The relationship between HAQ and HUI-3 utility was statistically significant (<0.0001), with good correlation (R2=0.63). The relationship between HAQ and EQ5D utility was also statistically significant (P<0.0001) with fair correlation (R2=0.40). CONCLUSIONS: In a tertiary referral centre population in Australia the HAQ appears to be the most appropriate measure for mapping RA disease severity to HRU. These results indicate these patients’ QOL cannot be predicted by clinical observations of TSJ alone, but is influenced by functional ability. HUI-3-derived utility has a stronger correlation with HAQ than EQ5D-derived utility with HAQ. The correlation between HUI-3 and HAQ is not surprising given the domain overlapping with these two instruments.