OBJECTIVES: Gastrointestinal malignancies are leading cause of death in the United States (US), with more than two thirds of gastrointestinal malignancies occurring in adults aged 65 years or older. However, little is known about the economic burden of gastrointestinal malignancies among older adults. Therefore, this study aimed to evaluate the annual economic burden of gastrointestinal malignancies among Medicare beneficiaries in the US.

METHODS: We conducted a cross-sectional study using data from the Medicare Current Beneficiary Survey (MCBS) 2017. Medicare beneficiaries aged 65 years or older were included, while the excluding criteria included end-stage renal disease (ESRD), disability, and Health Maintenance Organization (HMO). Gastrointestinal malignancies were identified based on the International Classification of Disease (ICD) codes, including 15.0.X to 15.9.X of ICD-9 and C15.X to C26.X of ICD-10. Descriptive analyses were used to identify the annual costs for patients with gastrointestinal malignancies. In addition, generalized linear models (GLM) with gamma distribution and log link were used to identify the incremental annual cost associated with gastrointestinal malignancies.

RESULTS: A total of 151 (1.2%) patients with gastrointestinal malignancies were identified out of 12,726 Medicare beneficiaries, with a mean annual cost of $19,796 [Standard deviation (SD)=31134]. The GLM-adjusted total annual costs of Medicare beneficiaries with gastrointestinal malignancies were 76.9% more than the costs of those without gastrointestinal malignancies, which was equivalent to $8037.43 [95% Confidence Interval (CI): $3854.1 -$12220.75]. In addition, although there were no significant incremental costs in inpatients, compared to beneficiaries without gastrointestinal, those with gastrointestinal malignancies had 2.24 (95% CI: 1.64–3.07) and 1.60 (95% CI: 1.17–2.19) times the economic burden of outpatients and medications, respectively.

CONCLUSIONS: Patients with gastrointestinal malignancies had a higher economic burden among Medicare beneficiaries, which was mainly reflected in outpatients and medications. Related measures might be needed to reduce the economic burden of patients.