OBJECTIVES: The evaluation of healthcare interventions – in particular in the context of health technology assessments (HTAs) – invariably implies some kind of (explicit or implicit) cost benefit analysis. One possible anchor is the value of a statistical life year (VSLY); however, currently used benchmarks for the willingness-to-pay (WTP) per life year gained are controversial and lack robust empirical support. Against this background, we reviewed and analyzed the economic literature reporting empirical data on the value of a statistical life (VSL), which were published between January 1995 and December 2020.

METHODS: Our updated systematic literature search identified 156 studies reporting original data, yielding 169 unique estimates for the VSL. After transformation of VSL into VSLY values, we expressed the VSLY – contingent on variables including regional origin of data, study design, and valuation method – in Euro (2019) and as multiples of annual gross domestic product (GDP) per capita. For regression analysis we used the ordinary least squares (OLS) model after log-transforming the VSLY estimates.

RESULTS: The median VSLY was €168,367 (mean, €256,701) or 6.3 times annual GDP/capita. The median VSLY [per GDP/capita] showed substantial differences by regional origin of data (North America, €288,994 [7.2] versus Europe, €168,367 [5.2]), study design (panel, €288,994 [7.7] versus cross-sectional data, €153,193 [5.6]), and valuation method (Revealed Preferences/Wage Risk, €274,625 [9.1] versus Stated Preference/Contingent Valuation, €113,246 [4.4]). Regression results indicate that studies with North American data sources reported significantly higher VSLY estimates, like those valuated with Revealed Preferences/Wage Risk and Revealed Preferences/Non-Occupational method; differences remained statistically significant after adjusting for GDP/capita. In contrast, our analysis showed statistically significant differences neither by study design nor by size of fatality risk.

CONCLUSIONS: Findings indicate that the empirical WTP for a statistical life year might be substantially higher than currently accepted international benchmarks for cost-effectiveness within the healthcare context.