OBJECTIVE: Health state utilities (‘utilities’) associated with heartburn based on patient preferences do not exist in the published literature. The objectives of our study were to assess utilities in GERD patients with heartburn in Germany and Sweden, and to analyze if the severity and frequency of heartburn and other patient characteristics may predict utilities. METHODS: One thousand eleven GERD patients with heartburn as the predominant symptom were recruited by their physicians and interviewed over the telephone. Utilities were assessed using the standard gamble (SG), time trade-off (TTO), EuroQol, and rating scale (RS) instruments. Another RS was used to assess the utility as the patients thought it would be without heartburn. Data were also collected about the severity (mild, moderate, severe) and the annual number of days with heartburn (‘frequency’). Linear regression analysis was used to estimate the prediction models. RESULTS: The reported SG, TTO, EuroQol, and RS utilities were on average 0.89, 0.88, 0.70, and 0.69. The RS utility as it would be without heartburn was 0.84. The prediction models showed that the EuroQol and RS utilities were negatively related to heartburn severity and frequency. A logarithmic transformation of heartburn frequency described the functional relationship between frequency and utilities best. The EuroQol, SG, and TTO utilities increased with age. Women reported lower EuroQol and RS utilities and higher SG utilities than men did. German patients reported lower RS utilities than Swedish patients did. The predicted EuroQol (and RS) utilities by severity of heartburn were 0.75 (0.72), 0.67 (0.67), and 0.50 (0.61). CONCLUSION: Our results indicate that patients assign substantial disability to heartburn. The results also indicate that utilities may be predicted from heartburn severity and frequency and other patient characteristics. The assessed utilities and the prediction models may provide a basis for future cost-utility analyses of GERD interventions. ALLERGY, EYE, EAR & SKIN DISEASES/DISORDERS