Treatment patterns and healthcare resource utilization in ruxolitinib-treated patients with myelofibrosis with and without anemia: a real-world analysis

Anemia affects many patients with myelofibrosis and is associated with poor prognosis. The Janus kinase inhibitor ruxolitinib is often used in myelofibrosis but may cause or worsen anemia. Using healthcare claims data from the IQVIA PharMetrics Plus database, this retrospective analysis evaluated healthcare resource utilization (HCRU), healthcare costs, and treatment patterns in ruxolitinib-treated patients with myelofibrosis stratified by anemia diagnosis prior to ruxolitinib initiation. Of 11,499 patients diagnosed with myelofibrosis between January 2011 and December 2022, 481 had ≥ 1 ruxolitinib claim on or after the myelofibrosis diagnosis date and were included in this analysis. Mean follow-up was 2.0 years. At baseline, anemic patients (n = 257) were older (mean age, 60.2 vs. 56.8 years; P < 0.001) and had a higher mean Charlson Comorbidity Index (1.0 vs. 0.5; P < 0.001) than nonanemic patients (n = 224). During follow-up, anemic patients exhibited higher median annual all-cause HCRU (inpatient admissions, 0.3 vs. 0.0 [P < 0.001]; outpatient visits, 40.0 vs. 20.0 [P < 0.001]; emergency department visits, 0.4 vs. 0.0 [P < 0.010]) and also had numerically higher median annual all-cause total healthcare costs ($198,491 vs. $170,419; P = 0.549) and medical costs ($44,830 vs. $12,017; P = 0.638) but significantly lower median annual total pharmacy costs ($129,381 vs. $136,686; P < 0.050), compared with nonanemic patients. Ruxolitinib discontinuation rates were higher and median time to discontinuation was approximately 1 year earlier in anemic patients (14.1 vs. 23.8 months; P < 0.010). In conclusion, patients with myelofibrosis and baseline anemia who are treated with ruxolitinib may be an HCRU-intensive population, suggesting a potential need for alternative treatments that reduce their medical resource burden.