Liu Tom, Fillbrunn Mirko, Zhang Shiyuan, Chen Jingyi, Li Weilong, Platt Julia, Niehoff Nicole, Sajeev Gautam, Signorovitch James
GSK plc, Philadelphia, PA, USA.
Analysis Group, Boston, MA, USA.
Ann Hematol. 2025 Mar;104(3):1605-1616. doi: 10.1007/s00277-025-06279-0. Epub 2025 Mar 12.
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.
贫血影响许多骨髓纤维化患者,并与预后不良相关。JAK激酶抑制剂芦可替尼常用于治疗骨髓纤维化,但可能导致贫血或使贫血加重。本回顾性分析利用IQVIA PharMetrics Plus数据库中的医疗索赔数据,评估了在开始使用芦可替尼治疗前根据贫血诊断分层的接受芦可替尼治疗的骨髓纤维化患者的医疗资源利用(HCRU)、医疗费用和治疗模式。在2011年1月至2022年12月期间诊断为骨髓纤维化的11499例患者中,481例在骨髓纤维化诊断日期或之后有≥1次芦可替尼索赔,并纳入本分析。平均随访时间为2.0年。在基线时,贫血患者(n = 257)比非贫血患者(n = 224)年龄更大(平均年龄,60.2岁对56.8岁;P < 0.001),且Charlson合并症指数更高(1.0对0.5;P < 0.001)。在随访期间,贫血患者的年度全因HCRU中位数更高(住院入院,0.3次对0.0次[P < 0.001];门诊就诊,40.0次对20.0次[P < 0.001];急诊科就诊,0.4次对0.0次[P < 0.010]),年度全因总医疗费用(198491美元对170419美元;P = 0.549)和医疗费用(44830美元对12017美元;P = 0.638)在数值上也更高,但年度总药房费用中位数显著更低(129381美元对136686美元;P < 0.050),与非贫血患者相比。贫血患者的芦可替尼停药率更高,停药中位时间早约1年(14.1个月对23.8个月;P < 0.010)。总之,接受芦可替尼治疗的骨髓纤维化和基线贫血患者可能是HCRU密集型人群,这表明可能需要替代治疗以减轻他们的医疗资源负担。