{
  "abstract": "Introduction Systemic sclerosis (SSc) is a chronic autoimmune connective tissue disease with widespread vasculopathy and progressive fibrosis. Diffuse cutaneous SSc (dcSSc) progresses faster than limited cutaneous SSc (lcSSc) and is associated with earlier organ complications and lower survival. Evidence on the economic impact of dcSSc over time remains limited. We quantified mean annual direct medical costs of Canadian dcSSc patients and described utilization patterns of healthcare resources (e.g., hospitalizations, outpatient visits and procedures) by disease duration (DD) in a large Canadian cohort.Material and Methods We analyzed cross-sectional data from the Canadian Scleroderma Research Group (CSRG). A total of 443 dcSSc patients from the CSRG database were divided by DD: group I (47%) with DD less than or equal to 5 years, group II (18%) with DD > 5 to less than or equal to 10 years, and group III (35%) with DD > 10 years, of whom 306 patients completed the Resource Utilization Questionnaire (RUQ). The 84-item RUQ captured past-year resource use including physician and allied health visits, diagnostic tests and procedures, assistive aids, alternative treatments, outpatient surgeries, inpatient hospitalizations, rehabilitative care, and related time commitments (travel, waiting, and time with providers). Annual direct medical costs were calculated by multiplying patient-reported utilization by unit costs from government fee schedules and other publicly available sources. Medication costs, not captured by the questionnaire, were derived from published Canadian cost sources. Costs are presented in 2025 Canadian dollars and summarized as per-patient annual means.Results Mean annual direct medical costs were highest in DD > 10 years ($25,934) and similar in DD 0–5 years ($21,886) and DD 5–10 years ($21,398). Utilization patterns differed across DD, with early disease associated with greater diagnostic testing and rheumatology visits, and later disease with relatively higher musculoskeletal and supportive care. Hospitalizations (34.7%), medications (31.4%), and practitioner visits (22.3%) were the largest contributors to total direct costs. Overall, mean annual direct medical cost was $22,990 per patient.Conclusions Patients with dcSSc have substantial direct medical costs in Canada, with costs increasing over time and shifting from early intensive monitoring and specialty care to later supportive and comorbidity-related care. Because only direct medical costs were assessed, total societal burden is under-estimated given potentially large indirect costs such as productivity loss and caregiver time. Further economic evaluations are needed to assess how emerging therapies may improve outcomes and reduce long-term burden.",
  "authors": [
    {
      "affiliations": [
        "St. Josephs Health Care, London. ON, Canada"
      ],
      "name": "Tatiana Nevskaya"
    },
    {
      "affiliations": [
        "Stage Analytics, Suwanne, Georgia, USA"
      ],
      "name": "Benjamin G Cohen"
    },
    {
      "affiliations": [
        "Stage Analytics, Suwanne, Georgia, USA"
      ],
      "name": "Francine Chingcuanco"
    },
    {
      "affiliations": [
        "Stage Analytics, Suwanne, Georgia, USA"
      ],
      "name": "Paul Steel"
    },
    {
      "affiliations": [
        "Therakos LLC, Bridgewater, NJ, USA"
      ],
      "name": "Isabelle Poirier"
    },
    {
      "affiliations": [
        "Therakos LLC, Bridgewater, NJ, USA"
      ],
      "name": "Vanita Sharma"
    },
    {
      "affiliations": [
        "St. Josephs Health Care, London. ON, Canada"
      ],
      "name": "Janet E Pope"
    }
  ],
  "title": "P.353 Economic burden of diffuse cutaneous systemic sclerosis in Canada",
  "uid": "5600b2ca-0621-5184-90d2-5be61268854f"
}