OBJECTIVES:  The annual number of new cases of pancreatic cancer was 12.4 per 100,000 men and women in the United States from 2009 to 2013. The mortality rate was 10.9 per 100,000 per year, which incurred approximately $1,500 million in health care costs. This study examined the health care utilization and economic burden of pancreatic cancer in the US Medicare population. METHODS:  Patients diagnosed with pancreatic cancer were identified (International Classification of Diseases, 9^th Revision, Clinical Modification diagnosis codes: 157.x) using national Medicare data from 01JAN2009-31DEC2013. The first diagnosis date was designated as the index date. Patients were required to have continuous medical and pharmacy benefits 1 year pre- and post-index date. Study outcomes, including health care costs and utilization, were evaluated and described for pancreatic cancer patients. RESULTS:  A total of 78,869 pancreatic cancer patients were identified. The mean age was 77 year (standard deviation [SD] =7.06). The majority of the patients were female (54.26%), white (83.58%), and resided in the South (33.66%) and Northeast (28.27%) US regions. The mean Charlson Comorbidity Index (CCI) score was 4.98 (SD=3.53). The most commonly diagnosed comorbid conditions included hypertension (80.77%), other malignancies (45.43%), and diabetes (44.3%). Health care utilization were assessed including the proportion of patients with inpatient (47.23%), emergency room (ER; 32.93%), physician office (97.44%), outpatient (88.24%), skilled nursing facility (SNF; 11.52%), home health agency (HHA; 26.96%), and durable medical equipment (DME; 49.07%) visits. Pancreatic cancer patients incurred higher health care costs, including inpatient ($21,550), ER ($497), physician office ($10,722), outpatient ($22,874), SNF ($2,984), HHA ($1,732), DME ($1,236), Part D pharmacy ($3,728), and total costs ($66,655). CONCLUSIONS:  During a 12-month period, Medicare patients diagnosed with pancreatic cancer reported high health care utilization and costs.