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Olofsson, S., Gerdtham, U. G., Hultkrantz, L. & Persson, U. (2019). Dread and Risk Elimination Premium for the Value of a Statistical Life. Risk Analysis
Open this publication in new window or tab >>Dread and Risk Elimination Premium for the Value of a Statistical Life
2019 (English)In: Risk Analysis, ISSN 0272-4332, E-ISSN 1539-6924Article in journal (Refereed) Epub ahead of print
Abstract [en]

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.

Place, publisher, year, edition, pages
Blackwell Publishing, 2019
Keywords
Cancer premium, VSL, risk elimination, stated preferences, willingness to pay
National Category
Cancer and Oncology
Identifiers
urn:nbn:se:oru:diva-74704 (URN)10.1111/risa.13341 (DOI)31194898 (PubMedID)
Available from: 2019-06-17 Created: 2019-06-17 Last updated: 2019-06-17Bibliographically approved
Olofsson, S., Gerdtham, U.-G., Hultkrantz, L. & Persson, U. (2019). Value of a QALY and VSI estimated with the chained approach. European Journal of Health Economics, 20(7), 1063-1077
Open this publication in new window or tab >>Value of a QALY and VSI estimated with the chained approach
2019 (English)In: European Journal of Health Economics, ISSN 1618-7598, E-ISSN 1618-7601, Vol. 20, no 7, p. 1063-1077Article in journal (Refereed) Published
Abstract [en]

The value of a quality-adjusted life-year (QALY) and the value of a statistical injury (VSI) are important measures within health economics and transport economics. Several studies have, therefore, estimated people's willingness to pay (WTP) for these estimates, but most results show scale insensitivity. The 'original' chained approach (CA) is a method developed to mitigate this problem by combining the contingent valuation (CV) with standard gamble (SG). In contrast to the version of the CA applied by the previous research of the WTP for a QALY, the original version allows the value of major health gains to be estimated without having the respondents express their WTP directly. The objective of this study was to estimate the value of a QALY and VSI in the context of non-fatal road traffic accidents using the original CA to test if the approach, applied to a wide range of health gains, is able to derive valid estimates and a constant value of a QALY which the previous research has not been able to show. Data were collected from a total of 800 individuals in the Swedish adult general population using two web-based questionnaires. The values of a QALY based on trimmed estimates were close to constant at €300,000 irrespective of the size of the QALY gain. The study shows that the original CA method may be a valid method to estimate the value of a QALY and VSI for major health losses. It also supports the use of a higher threshold value for a QALY than that which is currently applied by several health technology assessment agencies in different countries.

Place, publisher, year, edition, pages
Springer, 2019
Keywords
Chained approach, Contingent valuation, Quality-adjusted life-years, Scale sensitivity, Willingness to pay
National Category
Business Administration
Identifiers
urn:nbn:se:oru:diva-74652 (URN)10.1007/s10198-019-01077-8 (DOI)000480472300009 ()31172400 (PubMedID)2-s2.0-85067058474 (Scopus ID)
Funder
Swedish Transport Administration
Available from: 2019-06-10 Created: 2019-06-10 Last updated: 2019-08-29Bibliographically approved
Hultkrantz, L. (2018). Benefit-Cost Evaluation of Prevention and Early Intervention Measures for Children and Youth in Sweden. In: Mario La Torre, Mario Calderini (Ed.), Mario La TorreMario Calderini (Ed.), Social Impact Investing Beyond the SIB: Evidence from the Market. Paper presented at Social Impact Investments (SII) International Conference, Rome, Italy, October 11-12, 2017 (pp. 177-194). Cham, Switzerland: Palgrave Macmillan
Open this publication in new window or tab >>Benefit-Cost Evaluation of Prevention and Early Intervention Measures for Children and Youth in Sweden
2018 (English)In: Social Impact Investing Beyond the SIB: Evidence from the Market / [ed] Mario La TorreMario Calderini, Cham, Switzerland: Palgrave Macmillan, 2018, p. 177-194Conference paper, Published paper (Refereed)
Abstract [en]

This chapter reports on an on-going effort in Sweden to create a societal benefit-cost model for evaluation of causal effects of interventions for supporting children and young people at some developmental risk. This work is motivated by needs for such evaluation tools in planning, selection and follow-up of public and private impact investments. So far, modules have been created for economic evaluation of life-course, labour-market-related outcomes, some short- and medium-term cost offsets and the value of mortality and morbidity effects. On-going work includes estimation of the willingness to pay for suicide prevention and the costs of crime. However, as indicated by two case studies that are briefly summarised, even incomplete estimates of the benefit side are sometime sufficient to indicate high societal returns of early intervention and prevention measures.

Place, publisher, year, edition, pages
Cham, Switzerland: Palgrave Macmillan, 2018
Series
Palgrave Studies in Impact Finance
Keywords
Social impact investments, Benefit-cost analysis, Cost-effectiveness analysis
National Category
Economics
Research subject
Economics
Identifiers
urn:nbn:se:oru:diva-68625 (URN)10.1007/978-3-319-78322-2_7 (DOI)000460320300007 ()978-3-319-78321-5 (ISBN)978-3-319-78322-2 (ISBN)
Conference
Social Impact Investments (SII) International Conference, Rome, Italy, October 11-12, 2017
Available from: 2018-08-29 Created: 2018-08-29 Last updated: 2019-03-19Bibliographically approved
Andersson, H., Hultkrantz, L., Lindberg, G. & Nilsson, J.-E. (2018). Economic Analysis and Investment Priorities in Sweden's Transport Sector. Journal of Benefit-Cost Analysis, 9(1), 120-146
Open this publication in new window or tab >>Economic Analysis and Investment Priorities in Sweden's Transport Sector
2018 (English)In: Journal of Benefit-Cost Analysis, ISSN 2194-5888, E-ISSN 2152-2812, Vol. 9, no 1, p. 120-146Article in journal (Refereed) Published
Abstract [en]

Beginning as a planning tool within Sweden's national road administration some 50 years ago, benefit-cost analysis (BCA) has come to be a pillar of the national transport policy because of subsequent strategic choices made by the national parliament. These choices made it necessary to widen the analysis of costs to include also externalities and a foregone conclusion was that efficient investment priorities should be made based on BCA. But no one asked whether the political decision makers or the BCA models were up to that task. This paper reviews the institutional framework and practice of BCA in Sweden for transport infrastructure investment, and considers design issues that have been and still are debated, such as whether the discount rate should include a risk term and how to account for the marginal cost of public funds. A main concern with BCA results is the underestimation of construction costs, making transport sector projects look better than they are. Several ex post analyses have established that a higher NPV ratio increases the probability of being included in the investment program proposal prepared by the agency. The requirement to let projects undergo BCA seems to make planners trim project proposals by trying to reduce investment costs without significantly reducing benefits. This relationship is weaker among profitable projects. Moreover, there is no correlation between rate of return and the probability of being included in the final program, which is established on political grounds.

Place, publisher, year, edition, pages
Cambridge University Press, 2018
Keywords
benefit-cost analysis, rail, road, Sweden, transport sector institutions
National Category
Economics
Identifiers
urn:nbn:se:oru:diva-66992 (URN)10.1017/bca.2018.3 (DOI)000431405400006 ()
Note

Funding Agencies:

VTI  

Centre for Transport Studies, Stockholm 

Available from: 2018-05-18 Created: 2018-05-18 Last updated: 2018-08-31Bibliographically approved
Mantalos, P. & Hultkrantz, L. (2018). Estimating 'gamma' for tail-hedge discount rates when project returns are cointegrated with GDP. Applied Economics, 50(37), 4074-4085
Open this publication in new window or tab >>Estimating 'gamma' for tail-hedge discount rates when project returns are cointegrated with GDP
2018 (English)In: Applied Economics, ISSN 0003-6846, E-ISSN 1466-4283, Vol. 50, no 37, p. 4074-4085Article in journal (Refereed) Published
Abstract [en]

Martin Weitzman has suggested a method for calculating social discount rates for long-term investments when project returns are covariant with consumption or other macroeconomic variables, so-called tail-hedge discounting'. This method relies on a parameter called real project gamma' that measures the proportion of project returns that is covariant with the macroeconomic variable. We compare two approaches for estimation of this gamma when the project returns and the macroeconomic variable are cointegrated. First, we use Weitzman's own approach, and second a simple data transformation that keeps gamma within the zero to one interval. In a Monte-Carlo study, we show that the method of using a standardized series is better and robust under different data-generating processes. Both approaches are examined in a Monte-Carlo experiment and applied to Swedish time-series data from 1950-2011 for annual time-series data for rail freight (a measure of returns from rail investments) and GDP.

Place, publisher, year, edition, pages
Routledge, 2018
Keywords
Social discount rate, cost-benefit analysis, consumption CAPM, real project gamma
National Category
Economics
Identifiers
urn:nbn:se:oru:diva-68101 (URN)10.1080/00036846.2018.1441511 (DOI)000435001900007 ()2-s2.0-85042440814 (Scopus ID)
Available from: 2018-07-24 Created: 2018-07-24 Last updated: 2018-07-24Bibliographically approved
Hultkrantz, L. & Mantalos, P. (2018). Hedging with trees: Tail-hedge discounting of long-term forestry returns. Journal of Forest Economics, 30, 52-57
Open this publication in new window or tab >>Hedging with trees: Tail-hedge discounting of long-term forestry returns
2018 (English)In: Journal of Forest Economics, ISSN 1104-6899, E-ISSN 1618-1530, Vol. 30, p. 52-57Article in journal (Refereed) Published
Abstract [en]

Tail-hedge discounting is based on decomposition of returns from long-term investments in a fraction (gamma) that is correlated with consumption and another that is not. The first part is discounted at a discount rate that includes a risk premium, the other with the risk-free rate. We estimate gamma for forestry on Swedish data for stumpage prices and GDP per capita 1909-2012. We demonstrate that the result considerably changes the expected present value of medium-term and long-term forest investments.

Place, publisher, year, edition, pages
Elsevier, 2018
Keywords
Discounting, Far-distant future, Declining discount rates, Forestry, Forest economics, Cost-benefit analysis
National Category
Business Administration
Identifiers
urn:nbn:se:oru:diva-66586 (URN)10.1016/j.jfe.2018.02.001 (DOI)000428028000006 ()2-s2.0-85042597191 (Scopus ID)
Available from: 2018-04-13 Created: 2018-04-13 Last updated: 2018-04-13Bibliographically approved
Nystrand, C., Hultkrantz, L., Vimefall, E., Sampaio, F. & Feldman, I. (2018). Indicated Parenting Interventions and Long Term Outcomes: A Health Economic Modeling Study. In: : . Paper presented at ISPOR 8th Asia-Pacific Conference, Tokyo, Japan, September 8-11, 2018 (pp. S76-S76). Elsevier, 21
Open this publication in new window or tab >>Indicated Parenting Interventions and Long Term Outcomes: A Health Economic Modeling Study
Show others...
2018 (English)Conference paper, Poster (with or without abstract) (Refereed)
Abstract [en]

Economic evaluations of early interventions for children are augmenting in numbers and a larger focus is put on the longer-term economic returns. However, little is known about the labour market returns from preventive parenting programs. This study estimates the benefits and costs of five parenting interventions: Comet, Connect, the Incredible Years (IY), Cope and bibliotherapy, compared to a waitlist control, for the prevention of persistent externalizing behavior problems in children.

Place, publisher, year, edition, pages
Elsevier, 2018
Series
Value in Health, ISSN 1098-3015, E-ISSN 1524-4733
National Category
Economics
Identifiers
urn:nbn:se:oru:diva-70400 (URN)10.1016/j.jval.2018.07.571 (DOI)000458697200419 ()
Conference
ISPOR 8th Asia-Pacific Conference, Tokyo, Japan, September 8-11, 2018
Note

Camilla Nystrand presenterade abstractet på konferensen.

Available from: 2018-11-30 Created: 2018-11-30 Last updated: 2019-03-01Bibliographically approved
Hultkrantz, L. & Savsin, S. (2018). Is 'referencing' a remedy to hypothetical bias in value of time elicitation?: Evidence from economic experiments. Transportation, 45(6), 1827-1847
Open this publication in new window or tab >>Is 'referencing' a remedy to hypothetical bias in value of time elicitation?: Evidence from economic experiments
2018 (English)In: Transportation, ISSN 0049-4488, E-ISSN 1572-9435, Vol. 45, no 6, p. 1827-1847Article in journal (Refereed) Published
Abstract [en]

This paper demonstrates that commonly used methods for eliciting value of time can give downward bias and investigates whether this can be reversed by ‘referencing’ as has been suggested (e.g., by Hensher in Transp Res B 44:735–752,2010), i.e. with attributes of choice alternatives pivoted around a recently made journey. Value-of-time choice experiments were conducted in two rounds. In the first round, real and hypothetical purchases of performance of a simple time-consuming task were done to assess hypothetical bias; in the second round, participants were asked to do hypothetical travel choices with and without ‘referencing’ to a specific occasion, to be able to test ‘referencing’ as a remedy to the bias confirmed in the first round. A negative hypothetical bias was found for allocation of time at another occasion than the present (but not for a decision concern allocation of time ‘here and now’). A striking result was held from the second round experiments: ‘referencing’ indeed affects responses, but by reducing the elicited implicit value of time, so any negative hypothetical bias that would exist without ‘referencing’ would have been further magnified by the ‘referencing’ design.

Place, publisher, year, edition, pages
Springer, 2018
Keywords
Value of time, Stated choice, Certainty calibration, Referencing
National Category
Economics
Research subject
Economics
Identifiers
urn:nbn:se:oru:diva-59113 (URN)10.1007/s11116-017-9803-1 (DOI)000452336700013 ()2-s2.0-85027365064 (Scopus ID)
Available from: 2017-08-17 Created: 2017-08-17 Last updated: 2019-01-07Bibliographically approved
Hultkrantz, L. (2018). Kalkylräntan. Ekonomisk Debatt, 46(7), 50-54
Open this publication in new window or tab >>Kalkylräntan
2018 (Swedish)In: Ekonomisk Debatt, ISSN 0345-2646, Vol. 46, no 7, p. 50-54Article in journal (Other academic) Published
Place, publisher, year, edition, pages
Stockholm: Nationalekonomiska föreningen, 2018
National Category
Economics
Research subject
Economics
Identifiers
urn:nbn:se:oru:diva-70144 (URN)
Funder
VINNOVA
Available from: 2018-11-12 Created: 2018-11-12 Last updated: 2018-11-13Bibliographically approved
Olofsson, S. K., Gerdtham, U. G., Hultkrantz, L. & Persson, U. B. (2018). Measuring the end-of-life premium in cancer using individual ex ante willingness to pay. European Journal of Health Economics, 19(6), 807-820
Open this publication in new window or tab >>Measuring the end-of-life premium in cancer using individual ex ante willingness to pay
2018 (English)In: European Journal of Health Economics, ISSN 1618-7598, E-ISSN 1618-7601, Vol. 19, no 6, p. 807-820Article in journal (Refereed) Published
Abstract [en]

For the assessment of value of new therapies in healthcare, Health Technology Assessment (HTA) agencies often review the cost per quality-adjusted life-year (QALY) gained. Some HTA agencies accept a higher cost per QALY gained when treatment is aimed at prolonging survival for patients with a short expected remaining lifetime, a so-called end-of-life (EoL) premium. The objective of this study is to elicit the existence and size of an EoL premium in cancer. Data was collected from 509 individuals in the Swedish general population 20-80 years old using a web-based questionnaire. Preferences were elicited using subjective risk estimation and the contingent valuation (CV) method. A split-sample design was applied to test for order bias. The mean value of a QALY was MSEK4.8 (€528,000), and there was an EoL premium of 4-10% at 6 months of expected remaining lifetime. Using subjective risk resulted in more robust and valid estimates of the value of a QALY. Order of scenarios did not have a significant impact on the WTP and the result showed scale sensitivity. Our result provides some support for the use of an EoL premium based on individual preferences when expected remaining lifetime is short and below 24 months. Furthermore, we find support for a value of a QALY that is above the current threshold of several HTA agencies.

Place, publisher, year, edition, pages
Springer, 2018
Keywords
Willingness to pay, End of life, Value of a QALY, Cancer, Individual preferences, Contingent valuation
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:oru:diva-61723 (URN)10.1007/s10198-017-0922-6 (DOI)000435676600005 ()28803265 (PubMedID)2-s2.0-85027379799 (Scopus ID)
Note

Funding Agency:

Janssen Pharmaceutica NV 

Available from: 2017-11-07 Created: 2017-11-07 Last updated: 2018-07-24Bibliographically approved
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Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0003-1172-1076

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