Myelofibrosis Market Summary
The total market size in the 7MM for myelofibrosis was estimated to be nearly USD 2,600 million in 2025, and it is expected to grow positively by 2036. This change is mainly due to the increase in prevalence and the launch of upcoming therapies during the forecast period. The US had the largest market size for myelofibrosis in 2025, at nearly USD 2,000 million, compared to the EU4 (Germany, Italy, France, and Spain), the UK, and Japan.
JAK inhibitors have emerged as the centerpiece of pharmacologic therapy for patients with myelofibrosis, providing unprecedented benefits in terms of spleen shrinkage, symptom improvement, and quality of life. All approved JAK inhibitors target JAK2, but their effects on other molecules differ. JAKAFI is expected to go off patent in 2027 for Novartis and in 2028 for Incyte, creating a potential opportunity for emerging therapies. Coming therapies are focusing on different mechanisms other than JAK inhibitors, such as imetelstat (telomerase inhibitor), navtemadlin (MDM2 protein inhibitor), and pelabresib (BET inhibitor), among others.
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Myelofibrosis Overview
Myelofibrosis is a rare type of blood cancer characterized by the buildup of scar tissue, called fibrosis, in the bone marrow. The bone marrow cannot make enough healthy blood cells due to increased scar tissue. It is one of the related groups of blood cancers known as myeloproliferative neoplasms (MPNs) in which blood cells produced by bone marrow cells develop and function abnormally. When myelofibrosis develops on its own, it is called primary myelofibrosis. In other cases, another type of MPN, such as polycythemia vera or essential thrombocythemia, can transform into myelofibrosis, referred to as secondary myelofibrosis.
Myelofibrosis usually develops slowly and often does not cause early symptoms, frequently being discovered during a routine blood test. Several specific gene mutations have been identified in people with myelofibrosis, the most common being the Janus kinase 2 (JAK2) gene mutation, with other less common mutations including CALR and MPL. Prominent clinical features include anemia, hepatosplenomegaly, and constitutional symptoms such as fatigue, night sweats, low-grade fever, progressive cachexia, bone pain, splenic infarct, pruritus, thrombosis, and bleeding.
Myelofibrosis Diagnosis and Treatment Algorithm
Myelofibrosis can be diagnosed using a series of tests including blood tests, bone marrow tests, molecular testing, and mutation-enhanced morphologic diagnosis. To confirm the diagnosis, the doctor tests the bone marrow through two steps typically performed simultaneously: a bone marrow aspiration that removes a liquid marrow sample, and a bone marrow biopsy that removes a small amount of bone filled with marrow. Molecular tests are used for diagnosis and treatment planning to look for abnormal changes in genes, chromosomes, proteins, or other molecules within the patient’s cancer cells.
The only potential cure for myelofibrosis is allogeneic stem cell transplantation, though this procedure is risky for older patients and those with other health problems. For most patients, treatment is aimed at controlling disease symptoms and complications, enhancing quality of life, and extending survival. Drugs approved for treatment include JAKAFI/JAKAVI (ruxolitinib), INREBIC (fedratinib), VONJO (pacritinib), and OJJAARA/OMJJARA (momelotinib). For patients with low-risk symptoms, treatment options include ruxolitinib, interferon alfa, and hydroxyurea, while patients with intermediate and high risk may be treated with VONJO, JAKAFI/JAKAVI, INREBIC, and allogeneic stem cell transplantation.
Myelofibrosis Market Players
Key companies operating in the Myelofibrosis market research landscape include:
- Abbvie
- Morphosys
- Geron
- Bristol Myers Squibb
- Kartos Therapeutics
- Karyopharm Therapeutics
- Ns Pharma
- Galecto Biotech
- Actuate Therapeutics
- Merck
- Menarini Group
- Telios Pharma
- Disc Medicine
- Syntara
- Sumitomo Pharma
- Incyte
- And Others.
Myelofibrosis Epidemiology
The epidemiology section of the Myelofibrosis market insight report provides historical and projected patient population data across the seven major markets (7MM), supported by key opinion leader perspectives that contextualize observed and anticipated trends. Relevant tables and graphs offer a clear view of prevalence patterns, with disclosed assumptions ensuring transparency in data interpretation. This section provides a robust understanding of disease burden across regions.
Key Findings:
- Based on DelveInsight’s assessment in 2025, the 7MM had approximately 56,200 prevalent cases of myelofibrosis
- In the 7MM, the US accounted for the highest number of prevalent cases of myelofibrosis, with nearly 35% cases in 2025
- In 2025, EU4 and the UK accounted for nearly 54% cases of primary myelofibrosis and 46% cases of secondary myelofibrosis
- In 2025, there were about 56K total prevalent cases in the 7MM, expected to rise by 2034 due to improved detection, longer patient survival, and greater hematologist awareness
- The epidemiology of myelofibrosis is expected to evolve during the forecast period (2026–2036)
Myelofibrosis Market Outlook
The Myelofibrosis market trends point to continued expansion through the forecast period (2026–2036), driven by a rising prevalent population, technological advancements, and a growing pipeline of novel therapeutics. The total market size in the 7MM for myelofibrosis was estimated to be nearly USD 2,600 million in 2025 and is expected to reach USD 5,638 million by 2036, growing at a CAGR of approximately 9% during 2026–2036. Among EU4 and the UK, Germany had the largest market for myelofibrosis in 2025, while the UK had the least in the respective year. By 2036, among all the therapies, the highest revenue is expected to be generated by OJJAARA/OMJJARA.
Marketed Myelofibrosis Drugs
- JAKAFI/JAKAVI (ruxolitinib) – Incyte/Novartis
JAKAFI/JAKAVI (ruxolitinib) belongs to the class of medications called kinase inhibitors. It works by targeting JAKs, which control the production of blood cells, inhibiting overactive JAK signaling to help keep blood cell production under control. JAKAFI demand remains strong, and continued future growth is expected as it maintains its leadership as the standard of care in myelofibrosis.
- In November 2011, the US FDA approved JAKAFI for the treatment of adults with intermediate or high-risk myelofibrosis
- In August 2012, it received approval from the European Medicines Agency (EMA)
- In July 2014, it was approved in Japan
- JAKAFI is expected to go off patent in 2027 for Novartis and in 2028 for Incyte
- INREBIC (fedratinib) – Bristol Myers Squibb
INREBIC is an oral kinase inhibitor with activity against wild-type and mutationally activated JAK2 and FMS-like tyrosine kinase 3 (FLT3). It is a JAK2-selective inhibitor with higher potency for JAK2 over family members JAK1, JAK3, and TYK2. In cell models expressing mutationally active JAK2 or FLT3, INREBIC reduced phosphorylation of STAT3/5 proteins, inhibited cell proliferation, and induced apoptotic cell death.
- On August 16, 2019, the US FDA approved INREBIC for adults with intermediate-2 or high-risk primary or secondary myelofibrosis
- In February 2021, the European Commission granted full marketing authorization for INREBIC
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Emerging Myelofibrosis Drugs
The Myelofibrosis market size is expected to evolve significantly, supported by an active pipeline of emerging therapies addressing substantial unmet need. Key emerging candidates include XPOVIO (selinexor), RYTELO (imetelstat), navtemadlin, pelabresib, bomedemstat, and others, with active development programs targeting novel mechanisms, improved tolerability, and durable disease control.
- XPOVIO (selinexor) – Karyopharm Therapeutics
Selinexor is a first-in-class, oral Selective Inhibitor of Nuclear Export (SINE) compound that works by binding with and inhibiting the nuclear export protein XPO1, leading to the accumulation of tumor suppressor proteins in the cell nucleus. The drug has received Fast Track Designation and Orphan Drug Designation.
- According to Karyopharm Therapeutics’ third quarter 2025 financial results and business update (November 2025), top-line data from the Phase III SENTRY trial of selinexor plus ruxolitinib in myelofibrosis are expected in March 2026
- RYTELO (imetelstat) – Geron Corporation
Imetelstat is a first-in-class telomerase inhibitor being developed by Geron Corporation for the treatment of hematologic malignancies, including lower-risk myelodysplastic syndromes (LR-MDS) and myelofibrosis. It is currently in a Phase III trial.
- As per Geron’s corporate presentation (November 2025), the interim analysis of the Phase III IMpactMF trial of imetelstat in relapsed/refractory myelofibrosis is expected in 2H 2026, with the final analysis anticipated in 2H 2028
- Navtemadlin (KRT-232) – Kartos Therapeutics
Navtemadlin is an oral MDM2 protein inhibitor currently in Phase III development for primary and secondary myelofibrosis.
- Pelabresib (DAK539) – Novartis
Pelabresib is an oral BET inhibitor in Phase III development for primary and secondary myelofibrosis, being investigated as an add-on agent to ruxolitinib with strong late-stage data supporting combination use.
- Bomedemstat (IMG-7289/MK-3543) – Merck
Bomedemstat is an oral lysine-specific demethylase 1 (LSD1) inhibitor currently in Phase III development for primary and secondary myelofibrosis.
Myelofibrosis Drugs Uptake
This section examines the sales uptake of potential myelofibrosis drugs launched or anticipated to launch between 2022 and 2036, estimating market penetration across countries and evaluating their impact within and across therapeutic classes and segments. It also addresses the financial and regulatory factors contributing to the probability of success of drugs in the myelofibrosis market.
Emerging therapies are analyzed on the basis of safety and efficacy in randomized clinical trials, order of market entry, broader market dynamics, and the degree to which they address unmet need within the myelofibrosis treatment landscape.
Conclusion
The Myelofibrosis market is poised for meaningful growth through 2036, supported by an increasing disease burden, heightened awareness, and continued advancements in therapeutic innovation. While JAK inhibitors remain the cornerstone of treatment, persistent unmet needs – particularly in managing cytopenia, improving response durability, and addressing post-JAK inhibitor failure – are driving the development of next-generation agents with novel mechanisms and improved efficacy. Promising pipeline candidates such as XPOVIO (selinexor), RYTELO (imetelstat), navtemadlin, and pelabresib have the potential to reshape the treatment landscape and enhance patient outcomes. As research progresses and access to innovative therapies expands, the Myelofibrosis market is expected to witness significant transformation, creating new opportunities for stakeholders while addressing the long-term challenges associated with this debilitating condition.
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