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AbstractThe 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.

To decide how much resources to spend on reducing mortality risk, governmental agencies in several countries turn to the value of a statistical life (VSL). VSL has been shown to vary depending on the size of the risk reduction, which indicates that WTP does not increase near-proportional in relation to risk reduction as suggested by standard economic theory. Chained approach (CA) is a stated preference method that was designed to deal with this problem. The objective of this study was to compare CA to the more traditional approach contingent valuation (CV). Data was collected from 500 individuals in the Swedish adult general population using two web-based questionnaires, whereof one based on CA and the other on the CV method. Despite the two different ways of deriving the estimates, the methods showed similar results. The CV result showed scale insensitivity with respect to the size of the risk reduction and disease duration and resulted in more zero and protest response. The CA result did also vary depending on the procedure used, but not when chaining on individual estimates. The CA result was also found to be more sensitive to disease duration and severity. This study provides support for the validity of studies of the WTP for a risk reduction. It also shows that CA is associated with encouraging features for the valuation of non-fatal road traffic accidents, but the result does not support the use of one method over the other.