We have considered two attempts to link CBA and CEA. The first, by Johannesson and
Meltzer (1998), requires that incomes be held constant across individuals for WTP to be
proportional to the QALY gain. In relaxing this assumption, we find that health must be additively
separable to consumption in the utility function, since a relationship between health
and income would influence the ability of an individual to enjoy consumption. However,
this ‘link’ does not build a suitable bridge between CBA and CEA in the strict welfarist
sense since individual judgements (about the trade-offs between health and income) are
overruled in formulating a societal CBA. The second attempt to link CBA and CEA, by
Bleichrodt and Quiggin (1999), differs in that individual WTP figures are used. Whilst they
find conditions under which individuals would choose to maximise QALYs under a given cost-per-QALY threshold, this threshold will differ across individuals and, without a common threshold, their analysis is not consistent with a single implementation of CEA and so no substantive link exists here either