OBJECTIVES: To determine the preferences of the general public for health state descriptions of anaemia associated with cancer treatment. The majority of patients undergoing chemotherapy develop anaemia which leads to fatigue, and decreased quality of life (i.e. associated with a haemoglobin under 12g/dl). Treating cancer related fatigue has not been given the importance of other treatment related effects such as nausea. The present study was designed to estimate the utility decrement associated with increasing severities of anaemia. METHODS: Existing trial data was summarized in order to define health states related to the following haemoglobin levels: 7.0-8.0; 8.0-9.0; 9.0-10.0; 10.0-10.5; 10.5-11.0; 11.0-12.0; and 12+ g/dL. These health states were based on the FACT-An fatigue related items and were reviewed by clinicians and two quality of life experts. Forty interviews with the general public (recruited through advertisements) were conducted where participants were asked to rate the health states using a visual analogue scale (VAS) and standard gamble (SG). RESULTS: Mean (+95%CI) utility values were calculated for each health state anchored against death. The VAS scores ranged from 19.3±3.9 for 7-8g/dL Hb to 53.8 3±6.7 for 12+g/dL Hb. The standard gamble derived utility values showed a broadly linear change from 0.59 ±0.10 for 7-8g/dL Hb to 0.75 ±0.09 for 12+g/dL Hb. CONCLUSIONS: The health state utility scores show a linear decrement in line with worsening anaemia. These data underline the importance of cancer related fatigue for the general public.