Axial Spondyloarthritis Treatment Market - Global Industry Size, Share, Trends, Opportunity, and Forecast, Segmented By Therapy (Anti-Tumor Necrosis Factor (TNF) Therapy, Anti-Interleukin (IL) Therapy, Anti-Janus Kinase (JAK) Therapy), By Indication (Ankylosing Spondylitis v/s Non-radiographic Axial Spondyloarthritis Treatment), By End User (Hospitals & Clinics, Academic & Research Institutions, Others), By Region and Competition, 2020-2030F

Market Overview

The Global Axial Spondyloarthritis Treatment Market was valued at USD 4.37 billion in 2024 and is expected to reach USD 6.45 billion by 2030 with a CAGR of 6.70% during the forecast period. The global market for Axial Spondyloarthritis Treatment is experiencing significant growth, driven by rising incidence of axial spondyloarthritis and increasing public awareness of the disease are propelling the growth of the market. Axial spondyloarthritis is a chronic inflammatory condition that impacts the axial skeleton. The person suffers from severe discomfort, stiffness in the back area, and fatigue because of it. The other factors supporting the market’s growth are, growing world population, increasing research activities, surge in number of patients, large number of clinical trials, rising product innovation and development, significant investment in research and development, rising per capita health care expenditure, increasing prevalence of axial spondyloarthritis, growing number of mergers and acquisitions, and rising emphasis of several authorities on improving existing healthcare infrastructure.

Key Market Drivers

Growing Recognized Disease Burden and Rising Diagnosis/Referral Activity

Axial spondyloarthritis (axSpA), which includes non-radiographic axSpA and ankylosing spondylitis (AS), is increasingly recognized as a major cause of chronic back pain among young adults and a significant source of long-term disability. Population-based and registry studies indicate that the condition affects a meaningful minority of adults—prevalence estimates vary by geography and case definition but commonly fall in the range of a few per thousand up to roughly 1% in some populations. For example, reviews of epidemiology and national surveys suggest SpA prevalence up to ~1% in certain countries and that axSpA/AS are common enough to be a routine rheumatology workload. This baseline prevalence, combined with aging populations and greater attention to chronic musculoskeletal disease in national health agendas, translates into a steady absolute increase in the number of patients entering diagnostic pathways and needing long-term disease management.

Expanded Therapeutic Armamentarium and Guideline Endorsement of Biologic/Targeted Agents

Over the past 15 years therapeutic options for axSpA have expanded substantially, moving beyond NSAIDs, physiotherapy and conventional DMARDs to include biologic disease-modifying antirheumatic drugs (bDMARDs) and targeted agents. Tumor-necrosis-factor inhibitors (TNFi) were the first class to show robust efficacy in reducing spinal inflammation and improving function; more recently, IL-17 inhibitors (e.g., secukinumab, ixekizumab) and other targeted molecules have demonstrated benefit and received regulatory approvals in many jurisdictions. International guideline bodies—most recently the 2022 ASAS-EULAR recommendations—now explicitly incorporate bDMARDs and targeted therapies into treatment algorithms for patients with persistently high disease activity despite conventional measures. Those guideline endorsements, coupled with governmental and payer willingness to fund high-cost therapies for severe inflammatory diseases, materially expand the addressable market for biologics and small molecules in axSpA.

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Key Market Challenges

Long Diagnostic Delay, Under-Recognition and Gender Disparities

A persistent and well-documented obstacle to optimal axSpA care is delayed diagnosis and under-recognition. Numerous studies and meta-analyses report mean diagnostic delays measured in years — commonly 6–8 years from symptom onset to rheumatology diagnosis — a delay that is associated with worse structural damage, functional impairment, and psychological burden. The diagnostic gap is driven by several interacting factors: early disease often lacks definitive x-ray changes (non-radiographic axSpA), primary-care clinicians may interpret inflammatory back pain as mechanical low back pain, HLA-B27 prevalence varies by population and is not fully sensitive, and access to MRI (the imaging modality that detects early sacroiliitis) is uneven across health systems. Women are often particularly disadvantaged: multiple surveys show longer delays to diagnosis and atypical presentations that lead to misclassification.

High Cost, Access Inequities and Reimbursement Constraints for Biologics

Although targeted biologic therapies transform outcomes for many axSpA patients, their high acquisition costs create major access and sustainability challenges in public and private health systems. Biologics (TNFi, IL-17i) carry substantially higher prices than conventional therapies; public programmes report sharply rising biologic spending for inflammatory arthritides, and budgetary pressure prompts payers to impose restrictive criteria (e.g., failure of multiple NSAIDs, documented high disease activity, prior authorization). In the U.S., Medicaid and other public expenditures on biologic DMARDs have expanded considerably over the past decades, illustrating both growing clinical use and fiscal strain. High out-of-pocket costs in many countries result in treatment discontinuation, under-dosing, or delayed initiation—practices that degrade long-term outcomes and increase downstream costs from disability and lost productivity.

Key Market Trends

Treat-to-Target, Early Intervention and Outcome Registries Becoming Standard Practice

A major clinical trend reshaping the axSpA market is adoption of treat-to-target (T2T) principles, earlier use of effective therapies, and systematic outcome tracking via registries. Professional guidance and national rheumatology societies increasingly recommend aiming for low disease activity or remission and tailoring escalation of therapy accordingly. This approach requires earlier diagnosis, objective monitoring (e.g., MRI, CRP, validated activity indexes), and the willingness to escalate from NSAIDs to targeted agents if goals are not met—behaviours that raise demand for diagnostic services, imaging capacity, and biologic agents. Governments and payers in several countries now support national registries that track treatment patterns, safety signals and long-term outcomes for patients on biologics; these registries, in turn, inform reimbursement decisions and enable managed entry schemes that smooth access while monitoring effectiveness.

Biosimilars, Cost-Containment Strategies and Value-Based Care Reshaping the Market

Cost pressures and patent expiries have accelerated the entry of biosimilars for approved TNF inhibitors and other biologics used in axSpA. Governments and payers are actively promoting biosimilar uptake to contain costs while preserving patient access to effective biologic therapy. Evidence from budget-impact and health-economics studies shows that faster, broader conversion to biosimilars reduces treatment costs and can expand the number of patients treated under fixed budgets. Many public procurement agencies now pursue tendering, preferred-supplier lists, and incentives to switch where appropriate; some health systems couple biosimilar adoption with monitoring programs to ensure maintained outcomes.

Concurrently, value-based procurement and managed-entry agreements (outcomes-based contracts, indication-based pricing) are gaining traction as tools to share risk between manufacturers and payers while improving affordability. These approaches can accelerate market access for new agents (including novel mechanisms beyond TNF/IL-17) by linking payment to real-world effectiveness. For manufacturers and health systems, the trend favors more transparent pricing arrangements, investment in post-marketing evidence generation (registries, RWE studies), and product differentiation through service offerings (support for adherence, monitoring, patient education). Over time, biosimilars plus value-based models are likely to broaden access to effective therapies for axSpA while reshaping commercial strategies across the market.

Segmental Insights

Therapy Insights

Based on Therapy, Anti-Tumor Necrosis Factor (TNF) Therapy holds the largest market share in the global axial spondyloarthritis (axSpA) treatment market. TNF inhibitors, such as adalimumab, etanercept, infliximab, and golimumab, have been the cornerstone of axSpA management for over two decades, with strong clinical evidence supporting their efficacy in reducing inflammation, alleviating symptoms, and slowing disease progression. These therapies are often the first-line biologic treatment recommended for patients who do not respond adequately to conventional NSAIDs. According to the U.S. Centers for Medicare & Medicaid Services (CMS), biologics targeting TNF-alpha represent one of the largest segments of specialty drug spending, highlighting their widespread adoption in the treatment of rheumatologic diseases, including axial spondyloarthritis. The European Medicines Agency (EMA) and the U.S. Food and Drug Administration (FDA) continue to approve new biosimilars of TNF inhibitors, further expanding patient access and reinforcing the dominance of this therapy class. Additionally, TNF inhibitors are widely covered under national healthcare reimbursement programs in regions such as North America and Europe, which further strengthens their position as the leading therapeutic option.

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Regional Insights

Based on the region, North America holds the largest market share in the global axial spondyloarthritis treatment market. The region’s dominance is supported by its well-established healthcare infrastructure, strong availability of biologics and biosimilars, high healthcare expenditure, and the presence of leading pharmaceutical and biotechnology companies. According to the U.S. Centers for Medicare & Medicaid Services (CMS), national health expenditure in the United States reached USD 4.5 trillion in 2022, representing nearly 17.3% of GDP, which reflects the region’s capacity to adopt advanced and costly treatment options for chronic diseases such as axial spondyloarthritis. The U.S. and Canada also have high rates of early diagnosis due to widespread awareness campaigns and advanced diagnostic technologies, enabling more patients to access therapies at earlier stages of disease progression.

Recent Developments

• In June 2025, Johnson & Johnson reported positive Phase 3 APEX results for guselkumab in psoriatic arthritis, reinforcing IL-23 inhibition’s utility.
• In September 2024, UCB gained FDA approval for BIMZELX (bimekizumab-bkzx) across non-radiographic axial spondyloarthritis and ankylosing spondylitis.
• In July 2024, Spine BioPharma signed a USD 155 million deal with Ensol BioSciences to expand SB-01 indications into fibrotic diseases.
• In March 2024, AbbVie completed the USD 137.5 million acquisition of Landos Biopharma, adding oral NLRX1 agonist NX-13 to its pipeline.

Key Market Players

• Novartis AG
• Eli Lilly and Company
• Johnson & Johnson
• UCB S.A.
• Pfizer, Inc.
• Kyowa Kirin Co., Ltd.
• Merck & Co., Inc.
• AbbVie Inc
• Bristol-Myers Squibb Company
• FunPep Co., Ltd.

Report Scope:

In this report, the Global Axial Spondyloarthritis Treatment Market has been segmented into the following categories, in addition to the industry trends which have also been detailed below:

• Axial Spondyloarthritis Treatment Market, By Therapy:

o   Anti-Tumor Necrosis Factor (TNF) Therapy

o   Anti-Interleukin (IL) Therapy

o   Anti-Janus Kinase (JAK) Therapy

• Axial Spondyloarthritis Treatment Market, By Indication:

o   Ankylosing Spondylitis

o   Non-radiographic Axial Spondyloarthritis Treatment

• Axial Spondyloarthritis Treatment Market, By End User:

o   Hospitals & Clinics

o   Academic & Research Institutions

o   Others

• Axial Spondyloarthritis Treatment Market, By Region:

o   North America

§  United States

§  Mexico

§  Canada

o   Europe

§  France

§  Germany

§  United Kingdom

§  Italy

§  Spain

o   Asia-Pacific

§  China

§  India

§  South Korea

§  Japan

§  Australia

o   South America

§  Brazil

§  Argentina

§  Colombia

o   Middle East and Africa

§  South Africa

§  Saudi Arabia

§  UAE

Competitive Landscape

Company Profiles: Detailed analysis of the major companies presents in the Global Axial Spondyloarthritis Treatment Market.

Available Customizations:

Global Axial Spondyloarthritis Treatment Market report with the given market data, TechSci Research offers customizations according to a company's specific needs. The following customization options are available for the report:

Company Information

• Detailed analysis and profiling of additional market players (up to five).

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