Dread and Risk Elimination Premium for the Value of a Statistical Life

Abstract

The value of a statistical life (VSL) is a widely used measure for the value of mortality risk reduction. As VSL should reflect preferences and attitudes to risk, there are reasons to believe that it varies depending on the type of risk involved. It has been argued that cancer should be considered a “dread disease,” which supports the use of a “cancer premium.” The objective of this study is to investigate the existence of a cancer premium (for pancreatic cancer and multiple myeloma) in relation to road traffic accidents, sudden cardiac arrest, and amyotrophic lateral sclerosis (ALS). Data were collected from 500 individuals in the Swedish general population of 50–74‐year olds using a web‐based questionnaire. Preferences were elicited using the contingent valuation method, and a split‐sample design was applied to test scale sensitivity. VSL differs significantly between contexts, being highest for ALS and lowest for road traffic accidents. A premium (92–113%) for cancer was found in relation to road traffic accidents. The premium was higher for cancer with a shorter time from diagnosis to death. A premium was also found for sudden cardiac arrest (73%) and ALS (118%) in relation to road traffic accidents. Eliminating risk was associated with a premium of around 20%. This study provides additional evidence that there exist a dread premium and risk elimination premium. These factors should be considered when searching for an appropriate value for economic evaluation and health technology assessment.

Value of a QALY and VSI estimated with the chained approach

“…The VSI can be derived by multiplying the VSL by the relative utility loss of a non-fatal road traffic accident in relation to a fatal road traffic accident. The modelling approach has some limitations since it is restricted to contexts for which there are VSL estimates available (Olofsson et al, 2016a), assumes that the value of a QALY is independent of the type and number of QALYs gained which has been questioned theoretically (Hammitt, 2013), and requires specification of assumptions regarding discounting and the relation between VSL and expected remaining lifetime (Mason et al, 2009).…”

Is prevention of suicide worth less? A comparison of the value per statistical life

“…Previous research has shown that the VSL is dependent on context. For example, individuals are often willing to pay a higher premium to reduce the risk of dying from cancer than from other causes [9,[20][21][22]. 5 Johansson-Stenman and Martinsson (2008) found that respondents reveal a higher valuation of saving pedestrians than car drivers [23].…”

“…Furthermore, 63 percent stated that they thought society should take vigorous action to reduce the number of suicides, 8 while 23 percent agreed with the statement that each individual should be allowed to decide whether they would like to end their life. 9 Among those who stated a higher WTP for suicide prevention than traffic safety (n = 180), the main reason was "I think society does too little in this area" (n = 89), followed by "I think there are more possibilities to reduce the number of deaths within this area". Those who stated a higher WTP for traffic than suicide prevention (n = 157) stated, "I think it is more important to prevent an involuntary death then a voluntary death" (n = 62) and "I think there are more possibilities to reduce the number of deaths within this area" (n = 58).…”

“…(scale 0-10) 8. Defined as answering higher than six on the statement,"I think society should take vigorous actions to reduce the number of suicides" (scale 0-10) 9. Defined as answering higher than six on the statement, "Each individual should get to decide if he/she would like to end his/her own life; this is no one else's business" (scale 0-10).…”

Comparing mortality risk reduction, life expectancy gains, and probability of achieving full life span, as alternatives for presenting CVD mortality risk reduction: A discrete choice study of framing risk and health behaviour change

“…The effectiveness of these policies has been rarely assessed because an ex-post assessment requires certain conditions that are difficult to achieve (Capacci et al 2012). Using Stated Preferences (SP) previous studies have done ex-ante analysis and estimate the monetary benefits of programmes aimed at reducing the mortality risk of cardiovascular disease (Tolley et al, 1994, Cameron et al, 2008, Chestnut et al, 2012, Olofsson et al, 2016.…”