OBJECTIVES: Ankylosing spondylitis (AS) is chronic diseases leading to progressive disability. The Damage is progressive and irreversible with increased risk of spinal fracture. Peripheral joint involvement and extra-articular manifestations such as uveitis, inflammatory bowel disease and psoriasis may also occur. This leads to a significant impact on health care resources.( AS) Symptoms usually starting to appear between the age from 15 to 35 years, this age ranged population represent about 10 to13% of the whole Egyptian population which lead to increasing economic burden pressure on emerging market like Egypt. The objective of this study is to estimate the total medical cost of illness (COI) from the payer prospective for the last 3 years with analysis of treatments used. For recognize real cost in order to develop efficient treatment policy and also for implementation of efficient reimbursement plan. METHODS: Data from patients aged (18 -60 years ) for the last 3 years including direct and indirect medical costs for conventional treatment without Biologicals As it was not Reimbursed yet including ( cost of treatment, complications including physical therapy , hospitalization ,outpatients costs ). The total (n) of patients enrolled in the national database = 3212. One way sensitivity analysis was conducted. RESULTS: Mean total costs amounted to1390 dollar per patients for (AS) Number of patients increasing ratio was around 1.5% at the last 3 years. weighted avarge for costs was calculated. Majority of costs are related to managements of disease complications including treatment, hospitalization, consequences for poor physical function was 24 % with Cumulative percent 94 % and surgical procedures was 12%. The Incidence was about 3 times more common in men than in women. CONCLUSIONS:

Reimbursement of biological treatment should be implemented due to low response of current treatment specially at moderate and sever cases itroducing that line of treatment may lead to enahnce line of traetments and reduce complications of desis.