ObjectiveTo delineate steps in the intravenous (IV) treatment workflow with ravulizumab for paroxysmal nocturnal hemoglobinuria (PNH) from a healthcare system perspective and to identify steps that could potentially be simplified with an oral therapy. DesignIndividual in-depth semi-structured qualitative interviews were conducted with 5 US hematologists between October and December 2023. Participating physicians were from large medical centers (academic and community-based) experienced in treating PNH patients with IV ravulizumab. The interview data were analyzed to identify steps in the IV treatment workflow, leading to the development of a process map covering treatment decision/planning to outpatient administration. Physicians’ perspectives on process complexities related to IV treatment and steps that could be simplified through the adoption of an oral therapy were collected. ResultsThe approximate time from treatment decision to administration ranged from 2 to 4 weeks. Delays were primarily attributed to limited vaccination access in community settings and insurance approvals. Additional delays occurred, particularly for offlabel-dosing schedules, for example for breakthrough hemolysis, due to added complexity of obtaining insurance approvals. Patients spent an average of 3–4 hours for treatment administration at the infusion center. The lack of flexibility in scheduling, given that infusion centers were operating at full capacity, was noted. Hypothetically, with an oral treatment, alleviated steps would include treatment scheduling and administration at infusion centers. ConclusionsThe study revealed complexities associated with IV treatment with ravulizumab for PNH from a healthcare system perspective. Given that IV treatment is resource- and time-intensive for both patients and providers and that infusion centers are operating at full capacity, adopting an oral treatment could potentially enhance infusion center capacity and improve scheduling flexibility for other competing conditions. Further studies are warranted to understand the IV treatment burden from the perspectives of additional healthcare personnel (nurses, pharmacists) and patients.