OBJECTIVES: Anaemia is a common complication in cancer patients undergoing chemotherapy. Although quality-of-life (QoL) in CRA has been studied, utility values related to anaemia severity are lacking. The UK National Institute for Clinical Excellence (NICE) requests cost-utility analysis based on quality-adjusted life-years (QALY's) incorporating utilities elicited using public preferences. The objective was to use an appropriate method to estimate the impact of CRA, from a societal perspective. METHODS: A time-trade-off (TTO) questionnaire was designed and administered to a sample of laypeople: CRA health states were defined and described, based on the EuroQoL (EQ-5D) instrument, and the Functional Assessment of Cancer Therapy – Anaemia (FACT-An) instrument, and validated by clinical experts and cancer patients who had experienced anaemia. These descriptions were valued using the TTO elicitation method. Written informed consent was obtained and trained interviewers conducted surveys during February-March, 2004. RESULTS: In total, 110 respondents were interviewed; final analyses were performed on 106 respondents’ data. Resultant utility scores were converted to ratios, reflecting the baseline of ‘cancer and chemotherapy, with no anaemia’. Mean utility scores [SE] are 0.856 [0.014] for the no-anaemia state, and 0.781 [0.016], 0.615 [0.020] and 0.481 [0.020] for mild, moderate and severe anaemia states, respectively (Ratios of 1.00, 0.91, 0.72, and 0.56, respectively). CONCLUSIONS: This study strongly highlights a societal view that severity of cancer-related anaemia will significantly affect patient utility. For example, a change from no-anaemia to severe anaemia is predicted to approximately halve utility, independent of other factors. TTO appears to be a valid, and sufficiently sensitive method to highlight this effect. The ratios of relative effect are applicable to a range of ‘baseline’ cancer utilities as multiplicative factors to estimate impact of anaemia within this broader context. These results could be incorporated within appraisals of therapies for CRA, and satisfy certain health technology assessment criteria.