Martínez-Pérez, Jorge-EduardoSánchez-Martínez, Fernando-IgnacioAbellán-Perpiñán, José-MaríaPascual-Figal, Domingo2025-07-162025-07-162025-06Pharmacoeconomics. 2025 Jun;43(6):677-689.https://hdl.handle.net/20.500.12105/26830This study aims to estimate the value of a statistical life (VSL) in the context of atherosclerotic cardiovascular disease (ASCVD) in Spain using a contingent valuation/standard gamble (CV/SG) chained approach. The study employed a two-stage preference elicitation method that combined contingent valuation and a modified standard gamble technique. Specifically, willingness-to-pay and willingness-to-accept values were obtained for two health states depicting hypothetical outcomes following cardiovascular events. Subsequently, relative utility losses for the health states were derived using a modified standard gamble framing two risky choices. Chaining these elicited values allowed for VSL calculation without requiring direct valuation of small mortality risk reductions. The study was conducted through in-person interviews with a representative sample of 412 Spanish adults selected by stratified quotas. The estimated VSL range is from 1.59 to 2.06 million euros. Minor differences emerge between VSL figures on the basis of each of the two health states. These VSL estimates for ASCVD are congruent with the recent update of the official VSL estimated for Spain in the context of road traffic accidents, though the upper limit of the range is slightly higher (almost 9%). VSL estimates align with existing ranges in other European countries, particularly in the context of road safety, where a significant portion of existing studies is concentrated. Comparisons with other contexts, involving cardiovascular diseases, also lend support to the estimates presented here.Jorge-Eduardo Martínez-Pérez, Fernando-Ignacio Sánchez-Martínez, and José-María Abellán-Perpiñán gratefully acknowledge funding from grant PID2023-148357NB-I00 funded by MICIU/AEI/10.13039/501100011033 and by “ERDF/EU”. In addition, all authors express their gratitude for the fnancial support from Novartis España. Open Access funding provided thanks to the CRUE-CSIC agreement with Springer Nature. The funders had no role in the design, conduct, analysis, or interpretation of the study nor in the preparation, review, or approval of the manuscript. The publication of the study results was not contingent upon the sponsor’s approval or censorship of the fndings.engVoRhttp://creativecommons.org/licenses/by/4.0/Attribution 4.0 International40156683PharmacoEconomicsopen access