Elsevier

Value in Health

Volume 24, Issue 10, October 2021, Pages 1531-1541
Value in Health

Systematic Literature Review
How Much Is a Human Life Worth? A Systematic Review

https://doi.org/10.1016/j.jval.2021.04.003Get rights and content
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Highlights

What is already known about this topic?

Monetary valuation of a human life – the value of a statistical life (VSL) – is used in a broad range of policy areas resulting in a wide range of VSL estimates. Literature reviews and meta-analyses have generally focused on specific elicitation methods or sectors such as traffic or occupational risk. A review of VSL estimates using different elicitation methods across sectors would improve our understanding of recent developments and highlight future directions for research.

What does this article add to existing knowledge?

We included 120 studies which makes our study the most comprehensive review of VSL methods and estimates across sectors to date. The median of midpoint VSL estimates was $6.8 million, $8.7 million, and $5.3 million for the health, labor market, and transportation safety sectors, respectively. The variation in VSL depends mainly on the elicitation context (sector, developed/developing country, socio-economic status, etc) rather than the method used. Stated-preference techniques were the most common elicitation method.

What insights does this article provide for informing healthcare-related decision making?

We provide evidence that for policy evaluations context-specific VSL estimates, rather than one overarching average VSL estimate, ought to be used. Although stated- and revealed-preference elicitation methods yield comparable estimates within a sector, the VSL estimates for labor markets and developed countries tend to be higher. Overall, the VSL literature suggests that individuals value a life-year more highly than willingness-to-pay thresholds used in health technology assessment.

Abstract

Objectives

To systematically review studies eliciting monetary value of a statistical life (VSL) estimates within, and across, different sectors and other contexts; compare the reported estimates; and critically review the elicitation methods used.

Methods

In June 2019, we searched the following databases to identify methodological and empirical studies: Cochrane Library, Compendex, Embase, Environment Complete, Informit, ProQuest, PubMed, Scopus, and Web of Science. We used the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines for reporting and a modified Consolidated Health Economic Evaluation Reporting Standards checklist to assess the quality of included studies.

Results

We identified 1455 studies, of which we included 120 in the systematic review. A stated-preference approach was used in 76 articles, with 51%, 41%, and 8% being contingent valuation studies, discrete-choice experiments, or both, respectively. A revealed-preference approach was used in 43 articles, of which 74% were based on compensating-wage differentials. The human capital approach was used in only 1 article. We assessed most publications (87%) as being of high quality. Estimates for VSL varied substantially by context (sector, developed/developing country, socio-economic status, etc), with the median of midpoint purchasing power parity–adjusted estimates of 2019 US$5.7 million ($6.8 million, $8.7 million, and $5.3 million for health, labor market, and transportation safety sectors, respectively).

Conclusions

The large variation observed in published VSLs depends mainly on the context rather than the method used. We found higher median values for labor markets and developed countries. It is important that health economists and policymakers use context-specific VSL estimates. Methodological innovation and standardization are needed to maximize comparability of VSL estimates within, and across, sectors and methods.

Keywords

revealed preference
stated preference
systematic review
value of statistical life
VSL
willingness to pay

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