title: Burden of Friedreich's Ataxia to the Patients and Healthcare Systems in the United States and Canada.
abstract: OBJECTIVE
  The study intended to substantiate healthcare resource utilization, costs, and funding patterns of US and Canadian Friedreich's Ataxia (FRDA) populations, to assess compliance with treatment guidance and to identify areas where novel healthcare measures or improved access to existing care may improve patients' functional and social capabilities and reduce the financial impact on the healthcare systems.
  
  
  METHODS
  Healthcare resource utilization and costs were collected in a cross-sectional study in the US (N = 197) and Canada (N = 43) and analyzed across severity of disease categories. Descriptive statistics, correlation analysis, and hypothesis testing were applied.
  
  
  RESULTS
  In the US, healthcare costs of FRDA patients were higher than those of "adults with two and more chronic conditions." Significantly higher costs were incurred in advanced stages of the disease, with paid homecare being the main driver. This pattern was also observed in Canada. Compliance with the recommended annual neurological and cardiological follow-up was high, but was low for the recommended regular speech therapy. In the US public and private funding ratios were similar for the FRDA and the general populations. In Canada the private funding ratio for FRDA was higher than average.
  
  
  CONCLUSIONS
  The variety of healthcare measures addressing the broad range of symptoms of FRDA, and the increasing use of paid home care as disease progresses made total US healthcare costs of FRDA exceed the costs of US adults with two and more chronic conditions. Therefore, measures delaying disease progression will allow patients to maintain their independence longer and may reduce costs to the healthcare system. Novel measures to address dysarthria and to ensure access to them should be further investigated. The higher than average private funding ratio in Canada was due to the relatively high cost of the pharmacological treatment of FRDA.
authors.affiliation: Santhera Pharmaceuticals Ltd Liestal, Switzerland.
authors.forename: Barbara
authors.initials: B
authors.lastname: Polek
authors.forename: M J
authors.initials: MJ
authors.lastname: Roach
authors.forename: William T
authors.initials: WT
authors.lastname: Andrews
authors.forename: Manfred
authors.initials: M
authors.lastname: Ehling
authors.forename: Sam
authors.initials: S
authors.lastname: Salek
keywords: Friedreich ataxia; cost of illness; cross-sectional studies; healthcare resource; rare diseases; resource utilization