OBJECTIVES: To examine the economic burden and health care resource utilization of myeloproliferative neoplasms (MPNs) in the U.S. Medicare population. METHODS: A retrospective data analysis was performed using the U.S. national Medicare claims from January 2008 through December 2012. MPN patients were identified using International Classification of Disease 9^th Revision Clinical Modification (ICD-9-CM) diagnosis codes 238.4, 238.71, 238.76 and 289.83. The diagnosis date was designated as the index date. A comparison cohort without a MPN diagnosis was created for patients of the same age, region, gender, index year and baseline Charlson Comorbidity Index score. A random index date was chosen for the comparison cohort to reduce selection bias. Patients were required to have continuous medical and pharmacy benefits 1 year pre- and post-index date. One-to-one propensity score matching (PSM) was performed to compare follow-up health care costs and utilizations between the cohorts, adjusting for demographic and clinical characteristics.  RESULTS: Eligible patients (N=17,950) were identified for the MPN and comparison cohorts. After 1:1 PSM, a total of 5,546 patients were matched from each cohort and baseline characteristics were well-balanced. MPN patients had a higher percentage of health care resource utilizations, including Medicare carrier (98.6% vs. 65.9%), Durable Medical Equipment (DME; 29.5% vs. 14.4%), Home Health Agency (HHA; 12.4% vs. 5.0%), outpatient visits (76.6% vs. 37.4%), inpatient hospitalizations (27.2% vs. 6.8%) and Skilled Nursing Facility (SNF; 7.5% vs. 2.0%) visits than non-MPN patients. Patients diagnosed with MPNs also incurred significantly higher costs, including Medicare carrier ($3,872 vs. $1,283), DME ($266 vs. $91), HHA ($639 vs. $250), outpatient ($10,061 vs. $3,204), inpatient ($5,449 vs. $1,054), pharmacy ($1,069 vs. $713) and total health care costs ($23,060 vs. $7,076; p<0.0001).  CONCLUSIONS: MPN patients had a higher burden of illness compared to non-MPN patients.