Comprehensive Economic Analysis of Healthcare Costs in Ankylosing Spondylitis: Treatment Strategies and Socioeconomic Implications

ABSTRACT Background Ankylosing spondylitis (AS) is a chronic inflammatory disorder that imposes a significant economic burden through high healthcare costs. Prior studies have explored AS‐related expenditures, but a comprehensive analysis of cost‐related factors is lacking. This study aims to fill this gap. Methods We analyzed data from 6149 AS patients (2018–2024) at two tertiary hospitals in Guangxi, China, and classified them as surgical or non‐surgical; inpatients were categorized by catastrophic health expenditures (CHE; > 50% of household income). Descriptive statistics and the Kruskal–Wallis test were used to assess patient characteristics and cost differences, whereas propensity score matching and multivariable logistic regression were used to identify independent CHE predictors. Results A total of 6149 AS patients were included. Surgical patients were older and incurred significantly higher inpatient costs (USD 9457.21 vs. USD 1177.10 for non‐surgical patients). General medical service costs, imaging examination costs, Western medicine costs, and medical supply costs are risk factors affecting CHE in hospitalized patients. Conclusion AS imposes a substantial economic burden, particularly on surgical patients. Key cost drivers, including general medical services, imaging, pharmaceuticals, and medical supplies, markedly increase the risk of catastrophic expenditures. Implementing policy reforms to enhance insurance coverage, alongside clinical cost‐control strategies such as rational imaging use, adoption of generic medicines, and optimized management of medical supplies, is essential to alleviate financial strain and improve the sustainability of AS care.