Treatment Patterns and Healthcare Resource Utilization in Ruxolitinib-Treated Patients with Myelofibrosis with and without Anemia: A Real-World Analysis

OBJECTIVES: Anemia affects many patients with myelofibrosis and is associated with poor prognosis. The Janus kinase (JAK) inhibitor ruxolitinib, a standard of care for myelofibrosis, is often used regardless of patients’ anemia status, but it may worsen anemia. Using healthcare claims data, this analysis evaluated healthcare resource utilization (HCRU) in ruxolitinib-treated patients with myelofibrosis who were anemic or not before treatment.

METHODS: This retrospective study included patients with myelofibrosis in the IQVIA PharMetrics Plus database with ≥6 months of enrollment before (baseline) and 3 months after (follow-up) the first ruxolitinib prescription (index) following diagnosis of primary or secondary myelofibrosis. Baseline characteristics, treatment patterns, and per-patient per-year (PPPY) HCRU were analyzed by baseline anemia status.

RESULTS:: Of 11,499 patients with myelofibrosis, 481 met eligibility criteria during the study period (January 2011 to December 2022). Mean follow-up was 2.0 years (range, 0.3 to 9.3 years). Anemic patients (n=257) were older than nonanemic counterparts (n=224; mean age, 60.2 vs 56.8 years, P<.001), with a slightly higher male prevalence (58.0% vs 51.3%; P, nonsignificant). Anemic patients also had a higher Charlson Comorbidity Index (1.0 vs 0.5; P<.001) and more frequent thrombocytopenia (23.7% vs 8.0%; P<.001). Rates of suboptimal ruxolitinib treatment (a daily dose of <20 mg for 3 months post-index) were similar (20.9% vs 15.2%; P, nonsignificant). Anemic patients discontinued ruxolitinib ≈1 year earlier than nonanemic patients (median time to discontinuation, 14.1 vs 23.8 months; P<.01). During follow-up (from index to end of enrollment or data availability), anemic patients also exhibited higher average PPPY all-cause HCRU than those without anemia (inpatient admissions, 1.0 vs 0.5 [P<.001]; outpatient visits, 45.6 vs 27.1 [P<.001]; emergency department visits, 1.3 vs 0.7 [P<.01]).

CONCLUSIONS: Baseline anemic patients are an HCRU-intensive myelofibrosis population despite ruxolitinib treatment, highlighting the need for durable and effective treatments that reduce medical resource burden.