The Consumer Product Safety Commission’s regulation of disposable lighters was targeted at preventing injuries due to use of lighters by children not over 4 years of age. Based on a difference-in-differences analysis of national data for 1990–2019, this article estimates that the regulation reduced all injuries to the target population by 71%, burn injuries by 74%, and injuries severe enough to warrant admission to the hospital by 85% overall and by 84% for burn injuries. Unlike the counterproductive performance of safety cap regulations, this safety device enhanced safety levels in the target population group. The safety improvements from lighter safety devices outweigh any lulling effect of viewing products as being “childproof.” The regulation had a broader safety impact beyond the target population group, as it also reduced all types of injuries by at least 50% for children in the 5–17 age groups. Total annual risk reduction benefits were $940–$1465 million. A benefit-cost analysis based on a retrospective assessment of the regulation finds a more favorable impact than was anticipated.

The relationship between costs and health benefits of branded pharmaceuticals remains controversial. This paper examines the incremental costs incurred for incremental health benefits gained from the largest available sample of cost-effectiveness studies of branded drugs in the USA, the 1994–2015 Tufts Registry of Cost-Effectiveness Analyses. Earlier studies used small, specialized samples of drugs. We use linear regression analysis to estimate the association in those studies between additional quality-adjusted life years (QALYs) and incremental pharmaceutical costs. The preferred sample uses 476 studies involving branded pharmaceuticals with both higher costs and increased effectiveness compared to the previous standard of care. Regressions of costs on QALYs imply that an additional QALY is associated, on average, with a $28,561 increase in cost (95 % CI, $18,853–$38,270). This regression explains 20 % of the variation in sample costs. In this analytical sample, a share of the variation in the cost of pharmaceuticals is, therefore, not random but rather associated with variation in QALYs; prices are to some extent “value-based.” Our results are robust to varying sample inclusion criteria and to the funding source. In subgroup analyses, the highest cost per QALY was $44,367 (95 % CI, $35,373–$53,361). Costs of pharmaceuticals in this data set are, on average, lower than common estimates of the monetary value of a QALY to American consumers. As in other studies, we find that sellers of patent-protected beneficial new technology appear to capture only a fraction of the benefits provided.

The value of statistical life (VSL) is arguably the most important number in benefit–cost analyses of environmental, health, and transportation policies. However, agencies have used a wide range of VSL values. One reason may be the embarrassment of riches when it comes to VSL studies. While meta-analysis is a standard way to synthesize information across studies, we now have multiple competing meta-analyses and reviews. Thus, to analysts, picking one such meta-analysis may feel as hard as picking a single “best study.” This article responds by taking the meta-analysis another step, estimating a meta-analysis (or mixture distribution) of seven meta-analyses. The baseline model yields a central VSL of $8.0 m, with a 90 % confidence interval of $2.4–$14.0 m. The provided code allows users to easily change subjective weights on the studies, add new studies, or change adjustments for income, inflation, and latency.

Economic and health benefits assessments of air quality changes often quantify and report changes in deaths at a given point in time. The typical approach uses a method that attributes air pollution-related health impacts to a single year air quality change (or “pulse”). The perspective on benefits from these static pulse analyses can be enhanced by conducting a dynamic population assessment using life tables. Such analyses can provide a richer characterization of health risks across a population over a multiyear time horizon. In this article, we use the life table approach to quantify cumulative counts of reductions in PM-attributable deaths and life-years gained due to overlapping impacts of PM2.5 changes over a multiyear period, using case studies of air quality improvements in the USA and Chile. Our comparison of health risk and economic valuation for the two approaches shows life table analysis can be a valuable adjunct analysis to the pulse approach though both come with their own set of uncertainties and limitations. If applied jointly, they provide a broader characterization of how air quality actions can change populations in terms of life-years lost, life expectancy, and age structure. The value of these metrics is illustrated using case studies with dramatically different air quality reduction trajectories.

This article describes the process from first proposals in the early 1990s to project completion many years later for seven large Swedish road and railway projects. The purpose is to find reasons for the massive cost overruns as well as explanations for why projects are brought to completion despite much higher costs than when the decision to build was made. Cost overruns are set in an institutional context to highlight the interplay among national, regional, and local policymakers. National investment programs are seen as promises by other parts of society, irrespective of whether project costs increase during the process toward procurement and implementation. Another aspect is that the infrastructure manager’s administrative framework currently makes it impossible to compare costs in contracts with final cost, meaning that there is no institutionalized learning process in place. Design preparations and the estimation of costs for new projects must therefore be done without an understanding of what has been working well in the implementation of previous projects. While Benefit-Cost Analysis (BCA) played no role in the planning of the seven projects, the article sends a stark warning that early cost estimates provide poor input for assessing project rate of return.

Many economic analyses, including those that address the COVID-19 pandemic, focus on the value of averting deaths and do not include the value of averting nonfatal illnesses. Yet, incorporating the value of averting nonfatal cases may change conclusions about the desirability of the policy. While per case values may be small, the number of nonfatal cases is often large, far outstripping the number of fatal cases. The value of averting nonfatal cases is also increasingly important in evaluating COVID-19 policy options as vaccine- and infection-related immunity and treatments reduce the case-fatality rate. Unfortunately, little valuation research is available that explicitly addresses COVID-19 morbidity. We describe and implement an approach for approximating the value of averting nonfatal illnesses or injuries and apply it to COVID-19 in the USA. We estimate gains from averting COVID-19 morbidity of about 0.01 quality-adjusted life year (QALY) per mild case averted, 0.02 QALY per severe case, and 3.15 QALYs per critical case. These gains translate into monetary values of about $5300 per mild case, $11,000 per severe case, and $1.8 million per critical case. While these estimates are imprecise, they suggest the magnitude of the effects.