OBJECTIVES: Pemphigus and pemphigoid are a rare group of potentially fatal diseases, causing blistering on mucosal and epidermal surfaces. Long-term treatment with systemic corticosteroids and immunosuppressive agents such as intravenous immunoglobulin (IVIg) are usually required. Rituximab (RTX) is increasingly being used for autoimmune bullous dermatoses (AIBD) and has shown to be effective, however, in Canada, RTX is not approved for AIBD.  Given the potential cost associated with the use of RTX, there is a need to quantify the issues around accessing it for AIBD patients.  METHODS: Resources (e.g., treatment, lab costs, procedures, access to healthcare providers) associated with 89 AIBD patients were collected and quantified 6 months prior and 6 months post RTX initiation.  Costs of adverse events secondary to standard treatment (e.g., steroid adverse effects such as diabetes, cataracts, osteoporosis etc) and costs of medications used to prevent steroid adverse effects (e.g., proton pump inhibitors, bisphosphonates) were not calculated. Unit costs (2013 $CAN) were applied to the resources.  Overall cohort costs pre and post RTX, as well as cost per patient, were calculated.  Cost drivers were identified. RESULTS: The overall cohort cost for 6 months pre-RTX was $3.7million (M), and 6 months post was $2.6M (30.3% decrease). IVIg was shown to be the main cost driver. 6 months pre-RTX, 157 months of IVIG was used ($3.6M) compared to 71 months ($1.6M) 6 months post. The cost associated with access to healthcare resources significantly reduced from $46,715 vs. $22,978, and fewer visits to the dermatologist were required (377 vs. 256 visits). A decrease was also observed in the cost of specialist consultations required ($5,807 vs. $3,234) and other treatment/medication use ($64,548 vs. $48,045).  The cost per patient decreased ($41,497 vs. $28,923). CONCLUSIONS: RTX is effective in reducing the number of resources and costs associated with treatment of AIBD.