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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. [ABSTRACT FROM AUTHOR]

We investigate whether Swedish Environmental Protection Agency (EPA) administrator recommendations regarding improvements in environmental quality differ from citizen preferences. This is done by conducting identical choice experiments on both citizens and administrators at the EPA. The administrators were asked to choose the alternatives they would recommend as a policy, while the citizens were asked to act as private persons. We find that the rankings of attributes differ between the two groups and that the willingness to pay (WTP) obtained from the choices made by the administrators is higher for five out of the seven attributes, and in some cases the difference between the WTPs is substantial. [ABSTRACT FROM AUTHOR]

The willingness to pay (WTP) for different types of elements and other environmental qualities of the agricultural landscape were investigated by a choice experiment study. To get value measures of a set of attributes as policy relevant as possible, the WTP for 28 levels of 12 attributes was estimated. Two survey versions concerned permanent grassland and two concerned field elements of cultivated land. A sample of 8000 randomly selected Swedish inhabitants was used. The estimated values vary significantly between linear field elements and grassland types, where stone walls and oak-wooded pastures, respectively have the highest marginal WTP. Highly valued environmental qualities are biodiversity, visibility and absence of brushwood. Reference points were included to capture preference heterogeneity. The study cannot reject that respondents may value environmental service levels based on their reference points. [ABSTRACT FROM AUTHOR]

Abstract: This paper contributes with an applied policy analysis of the predator preservation policy in Sweden. We estimate the overall mean willingness to pay (WTP) for preserving the four large predators in the Swedish fauna by applying the contingent valuation method. Using survey data from 2004 we find that 50 percent of the Swedish population is willing to contribute financially toward implementation of the predator policy package, and that the estimated overall mean WTP is approximately SEK 290. Further, we test for spatial differences in attitudes and WTP and find that respondents in Stockholm have the highest overall mean WTP, while respondents living in wolf-territories have the lowest. Our mean WTP measure is flawed with upward bias, since we cannot estimate the willingness to accept for those with clearly negative preferences regarding the predator policy package (e.g. hunters). In this paper, we set their WTP equal to zero. Thus, we cannot rule out the possibility that the mean willingness to pay is, in fact, negative, i.e. the social-value of implementing the predator policy is negative. Finally, the estimates of the overall WTP are sensitive to response-uncertainty. When the respondents indicate uncertainty about their valuation, they tend to state higher values. [Copyright &y& Elsevier]

Mean willingness-to-pay (WTP) based on multiple bounded, discrete choice responses from contingent valuation surveys are normally obtained using some kind of parametric estimator. This paper instead exploits the possibility to interpret the response to the discrete-choice question as an implicit contract between the researcher and the respondent, resulting in a minimum legal WTP (MLW) estimator. Never previously used in valuation literature, it is used in this paper to estimate the WTP for the preservation of large carnivores in Sweden, based on a large scale, national survey. Results show that MLW estimates only were 12–19% of the comparable parametric estimates. In keeping with other results in contingent valuation literature, we find that the MLW estimates are positively related to the educational level, income and the fraction of urban population, while negatively related to age. Among the advantages of the MLW estimator is its transparency as well as the fact that it rests on a contractual notion of WTP. [ABSTRACT FROM AUTHOR]

Using identical surveys a decade apart, we examine how attitudes and willingness to pay (WTP) for climate policies have changed in the United States, China, and Sweden. All three countries exhibit an increased willingness to pay for climate mitigation. Ten years ago, Sweden had a larger fraction of believers in anthropogenic climate change and a higher WTP for mitigation, but today the national averages are more similar. Although we find convergence in public support for climate policy across countries, there is considerable divergence in both WTP and climate attitudes within countries. Political polarization explains part of this divergence. [ABSTRACT FROM AUTHOR]