OBJECTIVES: This study evaluated treatment patterns and costs among patients with pancreatic cancer (PC).   METHODS: A retrospective study analyzed data spanning January 2008-June 2012 from 3 large integrated claims databases. Adult patients with a diagnosis of PC (ICD-9 157.xx) were included if they had a minimum eligibility of 12 months prior and 3 months following their first PC diagnosis and had no diagnosis of cancer in the pre-period. Patients were categorized as having exocrine PC (ICD-9 157.0-157.3; 157.8-157.9), endocrine PC (ICD-9 157.4), or metastatic-exocrine PC (ICD-9 157.0-157.3; 157.8-157.9, 196.xx-199.xx). Treatment patterns, healthcare resource use, and all-cause costs (2012 USD) were evaluated after cancer diagnosis.  RESULTS: There were 2901, 6119, and 464 patients in each of the 3 databases meeting all inclusion criteria, respectively. The majority of patients had exocrine PC (97%-98%), with 40%-76% having metastatic disease. Patients were on average 60.3-64.5 (±11.3-14.0) years of age and 43%-52% were female. No treatment was received by 35%-55% of patients, 36%-55% of patients received chemotherapy ± radiation and/or surgery, and 9%-10% received radiation and/or surgery without chemotherapy. Second and third-line chemotherapy was received by 17%-32% and 9%-17% of patients, respectively. Among those with exocrine PC, patients with metastatic disease experienced an average of 0.25-0.31 inpatient, 2.3-2.9 office, 3.0-4.0 other outpatient visits and received 4.2-5.1 prescriptions per month vs 0.09-0.11 inpatient visits, 1.3-1.7 office visits, 1.3-1.9 other outpatient visits and 3.2-4.1 prescriptions per month in those without metastatic disease. Total monthly costs averaged $9,478-$12,042 and $1,022-$3,084 in patients with and without metastatic disease, respectively. The majority of costs were attributable to medical services ($7,977-$11,212 and $697-$2,852, respectively), with pharmacy costs contributing to a small proportion of the total costs ($830-$1,501 and $232-$326, respectively). CONCLUSIONS: Healthcare resource utilization and costs are highest among those with metastatic PC, totaling as much as $12,042 per month.