There is a need to value health technologies in a way that accommodates their broader economic impacts and competing approaches for doing so have emerged. The Pareto principle (PP) requires policymakers to resolve intrapersonal trade-offs by deferring to the preferences of the individuals facing those trade-offs. Many broad value frameworks such as cost-utility analysis and its extensions, health-centric multicriteria decision analysis, and poverty-free life expectancy are not sufficiently deferential to these preferences, violating PP. I propose using the health-augmented lifecycle model (HALM) to value health technologies in a way that flexibly incorporates the interactions among health and economic factors – specifically mortality and morbidity risks, paid and unpaid work, consumption, leisure, and public and private transfer inflows and outflows--over the life course. It relies on individual preferences, satisfying PP. It is compatible with cost-benefit analysis, social welfare functions, and equivalent income approaches. I calibrate the HALM for the US setting and apply it to a pediatric vaccine.

Compromised kidney function is associated with an array of environmental contaminants and pathogens that may be considered for regulation. However, there are few valuation estimates for kidney effects for use in benefit–cost analyses, particularly willingness-to-pay estimates. This paper is one of several surveys valuing morbidity developed by the OECD Surveys to elicit Willingness-to-pay to Avoid Chemicals-related negative Health Effects project, which aims to improve the basis for benefit–cost analyses. We report the results of a stated preference survey valuing reduced the risk of symptomatic chronic kidney disease, filling an important gap in the valuation literature and addressing a need for applied benefits analysis of chemical regulation. The survey was administered to representative samples in each of 10 countries: Canada, Chile, China, Denmark, Germany, Italy, Norway, Türkiye, the United Kingdom, and the United States. The mean (median) WTP for an average reduction of 3.5 in 1,000 of the risk of serious kidney disease over 5 years is $2,609 ($764), corresponding to a mean (median) value per statistical case (VSC) of chronic kidney disease of $805,000 ($224,000). The mean VSC varies between $700,000 for Canada and $1,200,000 for Türkiye.

Asthma is a non-communicable and non-curable lung disease that affects 10% of children and 4% of adults worldwide and is associated with an array of environmental contaminants and chemicals. This article offers values suitable for use in cost–benefit analyses of the willingness to pay (WTP) for reduced severity of asthma in adults and children and in reduced probability of getting asthma for these two population groups, all in the context of reducing chemical exposures. To this end, an online survey was administered between November 2021 and May 2022 to 12 727 respondents from seven countries of the Organisation for Economic Co-operation and Development (OECD). This article applies two stated preference methods for eliciting WTP: the contingent valuation method for reduced asthma severity and choice experiments for reduced probability of getting asthma of various severities. The context for such elicitations was a set of household products that contain fewer hazardous chemicals than what is currently available in supermarkets but are more expensive. The study finds that the WTP for reducing asthma severity in adults by one step, e.g. from “moderate plus” to “moderate”, is USD2022 529 per year on average. The parental WTP for reducing asthma severity in their children is USD2022 PPP 948 per year and is on average 1.8 times higher than their WTP for themselves. The mean value of a statistical case (VSC) of adult asthma which would be applied to predictions of new cases of asthma avoided by a regulation equals USD2022 280 000, while the mean VSC of childhood asthma equals USD2022 430 000.

Intentional violence against healthcare workers inflicts a physical and mental toll, motivating legislative proposals to better regulate these occupational risks. This article uses this context to address two novel issues for benefit assessment raised by injuries from assailants: potential heterogeneity in valuation based on the context of the injury risk and possible reductions in self-reported valuations when the exposed population has been trained to feel responsible for the risk. This article presents experimental evidence on workers’ preferences over the form of intervention: protection (risk reduction) or insurance (cost-sharing). The experiment also elicits worker valuations of occupational health care risks, calculating the value of a statistical injury (VSI), based on local wage-risk tradeoffs, in the general range of $200,000. Workers accord a premium to risk reductions that might eliminate the risk of injuries. Both the physical harm and the process by which the injury occurs may affect benefit assessments for the regulation of workplace violence. Non-healthcare participants require a $40,000 premium per expected injury resulting from intentional harm. While health care workers do not generally require such a premium, health care workers in clinical positions require more compensation to face occupational risks. Insurance coverage for monetary losses is more highly valued than protective measures for accidental harms, though there is no significant comparable preference for insurance against intentional harms. The results have important practical implications for addressing the concerning phenomenon of violence against healthcare workers, suggesting that expanding insurance compensation would be desirable, as would assigning an intentionality premium to intentional injuries.

We examine the effects of the postulated metric on the measurement of well-being, by comparing, in the (income, lifetime) space, two indexes: the equivalent income index and the equivalent lifetime index. The conditions under which the equivalent lifetime index exists are more restrictive than the ones under which the equivalent income index exists, but it is possible to define an alternative equivalent lifetime index, based on two reference income levels, for which the non-existence problem is less acute. Those indexes are also shown to satisfy different properties concerning interpersonal well-being comparisons, which can lead to contradictory rankings. While those incompatibilities arise under distinct indifference maps, we also explore the effects of the metric while relying on a unique indifference map, and show that, even in that case, the postulated metric matters for the measurement of well-being.

The compensating wage differential (CWD) for nonfatal injury and value of statistical life or injury in occupations have rarely been analysed separately by gender or race. This paper uses individual-level data from the 2012–2015 March Current Population Survey to estimate the CWD as well as the value of statistical injury (VOI) by race and gender. We find male workers command a positive risk premium, and this is higher when they are unionised. We also find a positive risk premium for White unionised workers and a slightly lower risk premium for White males. Like other investigators, we find that nonfatal risk is heterogenous, and its compensation is difficult to estimate using a standard wage equation, even with some smaller subsamples from our dataset that are gender- or race-specific. Our estimates of the VOI show us that male workers who are unionised have the highest VOI, followed by Hispanic union workers, and Black females. This last finding follows from Black females working in jobs that have the highest risk rates compared to White and Hispanic females.

A uniform value of a statistical life (VSL) is part of established practice within the federal government. Some people have applauded a uniform VSL on the ground that it respects the equality of persons; takes harm to poor people as seriously as it does harm to wealthy people; avoids expressive harms; and builds appropriate wealth redistribution into regulatory policy. Other people have strenuously objected to a uniform VSL, emphasizing that to reduce mortality risks, poor people are willing to pay less than rich people are, and urging that poor people should not have to pay more than they are willing to pay. Whether a uniform VSL is in the interest of poor people depends on whether we are dealing with subsidies or regulations. In the case of subsidies, a uniform VSL is highly likely to benefit poor people. If we are dealing with regulations, we cannot know whether a uniform VSL helps or harms poor people without knowing the incidence of costs (and benefits).

Regulatory impact analyses of proposed environmental, occupational, and consumer product safety regulations often rely on a metric known as the Value per Statistical Case of Cancer (VSCC), that is, the public’s willingness to pay (WTP) for reductions in the risk of developing cancer. In this paper, we ask whether the VSCC depends on cancer survival prospects. We develop a simple theoretical model that shows that under standard assumptions the VSCC is decreasing in the chance of surviving cancer. We empirically test this prediction by means of a stated preference survey, where we ask subjects aged 45–60 from the general population in the Czech Republic to report information about their WTP for reductions in the risk of getting cancer. One half of the sample was told that, if they got cancer, the 5-year survival rate was 60 % (corresponding to the average survival chances across all types of cancer), while the other half was told that it was 75 %. Consistent with the theoretical model, we find that the VSCC is larger in the former group. The ratio between the VSCC of the two groups is approximately equal to the ratio between the conditional cancer mortality risks implied by the survey’s survival rates, suggesting that the VSCC is proportional to conditional cancer mortality. Our findings have important policy implications in the context of regulations that focus on pollutants linked to cancers with different chances of survival.

The value of statistical life (VSL) is arguably the most important number in benefit–cost analyses of environmental, health, and transportation policies. However, agencies have used a wide range of VSL values. One reason may be the embarrassment of riches when it comes to VSL studies. While meta-analysis is a standard way to synthesize information across studies, we now have multiple competing meta-analyses and reviews. Thus, to analysts, picking one such meta-analysis may feel as hard as picking a single “best study.” This article responds by taking the meta-analysis another step, estimating a meta-analysis (or mixture distribution) of seven meta-analyses. The baseline model yields a central VSL of $8.0 m, with a 90 % confidence interval of $2.4–$14.0 m. The provided code allows users to easily change subjective weights on the studies, add new studies, or change adjustments for income, inflation, and latency.

The Consumer Product Safety Commission’s regulation of disposable lighters was targeted at preventing injuries due to use of lighters by children not over 4 years of age. Based on a difference-in-differences analysis of national data for 1990–2019, this article estimates that the regulation reduced all injuries to the target population by 71%, burn injuries by 74%, and injuries severe enough to warrant admission to the hospital by 85% overall and by 84% for burn injuries. Unlike the counterproductive performance of safety cap regulations, this safety device enhanced safety levels in the target population group. The safety improvements from lighter safety devices outweigh any lulling effect of viewing products as being “childproof.” The regulation had a broader safety impact beyond the target population group, as it also reduced all types of injuries by at least 50% for children in the 5–17 age groups. Total annual risk reduction benefits were $940–$1465 million. A benefit-cost analysis based on a retrospective assessment of the regulation finds a more favorable impact than was anticipated.

The value of a statistical life (VSL) establishes the money-risk tradeoff that U.S. government agencies have used for four decades to monetize the mortality reduction benefits of proposed regulations. This article advocates the adoption of the VSL more generally both for policy evaluation purposes and for setting the magnitude of regulatory sanctions involving fatalities. Agencies currently employ the inconsistent practice of using the VSL to set the stringency of regulations, while at the same time, reverting to very low monetary values of sanctions for violations that result in fatalities. Reform of penalty levels to reflect the VSL will require increasing the current statutory limits on regulatory penalties. Revamping the penalty structure also will incentivize private companies to incorporate the VSL in their corporate risk analyses. Government agencies, including those concerned with national defense, similarly could profit from greater expansion of the use of the VSL in policy decisions.

The value of the risk to life is a key element for benefit-cost analysis, enabling more rational public policy decisions in diverse areas as environmental, health, and crime. We value the risk to life in the context of crime using a discrete choice experiment (CE). The method has clear advantages in that it applies to the whole population and does not require vast data from labor markets, for example. Such data are not always available even in developed economies. Combining the stated preference approach with contingent valuation (CV), CE offer advantages yet to be explored in the context of crime. We demonstrate the application in a developing economy, where similar valuations are not available. The best estimate obtained for Argentina is an average of 1.5 million in 2015 US dollars per statistical life with a confidence interval ($1.1–$2.3). This result is consistent with estimates for the developed world, after appropriate transfer. We also analyze demographic factors in the risk to life, finding a positive influence of income, risk aversion, previous victimization experience and family size on the value of a statistical life, as well as a negative impact of individualism.

Examination of estimates of the income elasticity of the value of a statistical life based on international stated preference studies yields an average between 0.94 and 1.05 overall and 0.65 and 0.80 after controlling for covariates. Quantile regression estimates indicate that the income elasticity is about 0.55 for more affluent countries and 1.0 for lower income nations, i.e., those countries that have estimates of the value of a statistical life below $2 million or per capita income levels below $3212. The estimates distinguish the values of the income elasticity across country either by income level or by the value of a statistical life. These elasticities are similar to those found in revealed preference labor market studies. The estimates are robust, controlling for possible sample selection bias and the influence of covariates, such as the type of risk.

The European Union’s regulation for chemical safety (REACH) addresses the registration, evaluation, assessment, and consequent authorization (or restriction) of chemicals which are potentially harmful for both public health and the environment. The current study aims at ascertaining the costs and benefits of the REACH framework for the Austrian economy under major uncertainties, and draws on a wide range of databases on public and workplace health, chemical accidents in households, and the potential environmental impacts of harmful chemicals.

The uncertainties in the REACH system assessments of the effects of chemicals on health lie not only in the insufficiency of scientific evidence but also in the economic evaluation of effects on health, especially in regard to the value of statistical life (VSL), and the economic value of diseases attributed to chemicals.

This benefit-cost analysis (BCA) of the REACH system in Austria therefore takes into account these manifold uncertainties by designing a conservative baseline scenario and by varying all determinants in comprehensive sensitivity analyses. Projected over a period of about 30 years, this paper provides evidence that the REACH system most probably leads to net benefits for the Austrian economy (benefit-cost ratio of about 10.6) even though many benefits are still highly uncertain or unknown.

Selection of the best estimates of economic parameters frequently relies on the “best estimates” or a meta-analysis of the “best set” of parameter estimates from the literature. Using an all-set dataset consisting of all reported estimates of the value of a statistical life (VSL) as well as a best-set sample of the best estimates from these studies, this article estimates statistically significant publication selection biases in each case. Biases are much greater for the best-set sample, as one might expect, given the subjective nature of the best-set selection process. For the all-set sample, the mean bias-corrected estimate of the VSL for the preferred specification is $8.1 million for the whole sample and $11.4 million based on the CFOI data, while for the best-set results, the whole sample value is $3.5 million, and the CFOI data estimate is $4.4 million. Previous estimates of huge publication selection biases in the VSL estimates are attributable to these studies’ reliance on best-set samples.

Countries throughout the world use estimates of the value of a statistical life (VSL) to monetize fatality risks in benefit-cost analyses. However, the vast majority of countries lack reliable revealed preference or stated preference estimates of the VSL. This article proposes that the best way to calculate a population-average VSL for countries with insufficient or unreliable data is to transfer a base VSL from the United States calculated using labor market estimates from Census of Fatal Occupational Injuries data, coupled with adjustments for differences in income between the United States and the country of interest. This approach requires estimation of two critical inputs: a base U.S. VSL and the income elasticity of the VSL. Drawing upon previous meta-analyses that include adjustments for publication selection biases, we adopt a base VSL of $9.6 million. We utilize a sample of 953 VSL estimates from 68 labor market studies of the VSL covering fourteen lower-middle income to high income nations. We estimate the income elasticity of the VSL within the United States to be from 0.5 to 0.7 and to be just above 1.0 for non-U.S. countries. Quantile regression reveals that much of the disparity in income elasticities is attributable to income differences between the United States and other countries, as the income elasticity increases for lower income populations. Using income classifications from the World Bank, we calculate average VSLs in lower income, lower-middle income, upper-middle income, and upper income countries to be $107,000, $420,000, $1.2 million, and $6.4 million, respectively. We also present VSL estimates for all 189 countries for which World Bank income data are available, yielding a VSL range from $45,000 to $18.3 million.

Individuals who are compromised in their ability to either believe in or plan for their future will make very different valuations of future benefits than will those who have more means and capabilities. These valuations could apply across a wide spectrum, from health care and insurance to investments in education to retirement savings. Data based on time trade-offs and other hypothetical questions will lead to large gaps in contingency valuations which, taken at face value, would lead to regressive outcomes. Individuals who discount the future are unlikely to be responsive to information intended to mitigate risk or to nudges designed to guide behavior away from risky choices. For example, these differential responses result in particular preventive policies having much less than the intended benefit values. Subjective well-being metrics can help circumvent the problem by comparing the reported well-being of individuals who are actually in different arrangements, such as those who have taken up health insurance or not, or in different work arrangements. Still, subjective well-being metrics are a compliment and not a substitute for the standard data that is used in BCA.

The value of a statistical life (VSL) is the most influential single parameter used in calculating the benefits of governmental regulations. While there are some interagency differences, there is a commonality in the conceptual approach, the central role of mortality risk valuation in benefit assessment, and the general range of valuations used. Corporate risk decisions are based on a less rigorous risk analysis procedure. As typified by the General Motors ignition switch recall problems and the company’s lax corporate safety culture, there is often little systematic corporate balancing of cost and risk. This suppression of safety concerns may be attributable to the adverse experiences automobile companies had after conducting risk analyses that valued fatalities based on damages awards for wrongful death, and in response juries levied blockbuster punitive damages awards. Instead, companies should adopt the VSL in its product risk decisions. Companies should also be provided with a safe harbor reference point for responsible risk decisions. Regulatory agencies should use the VSL in setting regulatory sanctions.