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Background: Life-threatening illnesses in young people are traumatic for patients and their families. Support services can help patients and families deal with various non-medical impacts of diagnosis, disease and treatment. The aim of this study was to determine which types of support are most valued by adolescents and young adults (AYA) with cancer or blood disorders and their families. Method: A discrete choice experiment (DCE). Separate experiments were conducted with AYA and their carers. Results: Completed surveys were returned by 83 patients and 78 carers. AYA preferred emotional support for themselves (either by counsellors and/or peers), emotional support for their family, financial support and assistance returning to school/work over services relating to cultural and spiritual needs. Covariate analysis indicated female AYA were more likely than males to prefer emotional support, while males were more likely to prefer assistance returning to work/school. Carers preferred emotional support for their AYA and assistance returning to school/work. Like AYA, they were indifferent about services relating to cultural and spiritual needs. Conclusion: Providing the types of support services that people prefer should maximise effectiveness. This study suggests that AYA patients require support services that included financial aid, assistance returning to work/study, emotional support for themselves and for their family. © 2012 Elsevier Ireland Ltd.

Objective: The aim of this study was to explore the views and perceptions of stakeholders about the current national health technology assessment process conducted by the Medical Services Advisory Committee (MSAC) and its role in the uptake and diffusion of new medical technologies in Australia. Methods: Data collection occurred over a nine month period (August 2008-April 2009). Twenty in-depth, semi-structured interviews were conducted with individuals from four stakeholders groups: (i) MSAC members and evaluators, (ii) academic and health technology assessment experts, (iii) medical industry representatives and (iv) medical specialists. Interviews were digitally recorded, transcribed verbatim and coded using a constant comparative method. Results: Respondents expressed a consensus opinion that the MSAC process is generally fair and transparent, and has been increasingly so over time. The process was described as " flexible" and " intuitive" yet also " idiosyncratic" due to the nature of the technologies being appraised. Approval by MSAC was generally reported to be increasingly important once a technology becomes more widely used. While successful MSAC approval was felt to be important for widespread distribution of a new technology, it was viewed more as a " facilitator of the uptake of new technologies" as opposed to a primary " driver" of technology uptake. Instead, other factors were identified as providing the actual impetus for the uptake of new technologies, with MSAC approval and reimbursement eventually helping facilitate more widespread diffusion. Conclusions: MSAC's decision making process is perceived as fair but with room for improvement. Its role in the uptake and diffusion of new medical technologies in Australia is limited. MSAC does not act as a barrier to significant market penetration of new procedures and medical technologies. However reimbursement is a trigger for increased use. © 2011 Elsevier Ireland Ltd.

Objective: Governments are increasing their focus on mandatory public health programmes following positive economic evaluations of their impact. This review aims to examine whether loss of consumer choice should be included in economic evaluations of mandatory health programmes (MHP). Method: A systematic literature review was conducted to identify economic evaluations of MHP, whether they discuss the impact on consumer choice and any methodological limitations. Results: Overall 39 economic evaluations were identified, of which 10 discussed the loss of consumer choice and 6 attempted to place a value on the loss of consumer choice. Methodological limitations included: measuring the marginal cost of compliance, unavailability of price elasticity estimates, the impact of income effects, double counting health impacts, biased willingness-to-pay responses, and "protest" responses. Overall it was found that the inclusion of the loss of consumer choice rarely impacted on the final outcome of the study. Conclusion: The impact of MHP on the loss of consumer choice has largely been ignored in economic evaluations. Its importance remains uncertain due to its infrequent inclusion and significant methodological limitations. Further research regarding which methodology is best for valuing the loss of consumer choice and whether it is important to the final implementation decision is warranted. © 2010 Elsevier Ireland Ltd.