Effects of Clinical and Socioeconomic Factors on Medicare and Patient Costs for Colorectal Cancer in Australia - A Retrospective Multivariate Regression Analysis

Sep 21, 2026

Objective: Examine how clinical and socioeconomic factors shape colorectal cancer (CRC) costs for patients and Medicare in Australia, extending limited local evidence. Design: Using the Victorian Cancer Registry, include CRC diagnoses from 2010–2019 and link 2010–2021 Medicare records covering Pharmaceutical Benefits Scheme and Medicare Benefits Schedule expenses. Methods: Apply descriptive and log-linear multivariate regressions across stage, CRC type, molecular profile, metastasis, and demographics (age, birth country, SEIFA socioeconomic level, native language). Results show higher costs with advanced stage, with OOP averages around $A441 per year.

LanguageEnglish

CategoryResearch & Report

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Pages9

Reading Time23 min

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Abstract

Strengths and Limitations of This Study

Introduction

Open access Original research Effects of clinical and socioeconomic factors on Medicare and patient costs for colorectal cancer in Australia: a retrospective multivariate regression analysis Ou Yang ,1 Yuting Zhang,1 Yat Hang To,2 Maarten M J IJzerman,3,4 Judith Liu,5 Peter Gibbs,2 Karen Trapani,3 Sallie-Anne Pearson,6 Fanny Franchini,3 The PRIMCAT Group To cite: Yang O, Zhang Y, To YH, et al. Effects of clinical and socioeconomic factors on Medicare and patient costs for colorectal cancer in Australia: a retrospective multivariate regression analysis. BMJ Open 2024;14:e081483 . doi:10 . 1136/ bmjopen-2023-081483 ► Prepublication history and additional supplemental material for this paper are available online. To view these files, please visit the journal online ([https://doi.org/10.1136/](https://doi.org/10.1136/)[ ](https://doi.org/10.1136/)[bmjopen-2023-081483](bmjopen-2023-081483)) . Received 30 October 2023 Accepted 17 November 2024 © Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. For numbered affiliations see end of article. Correspondence to Dr Ou Yang; [ou.yang@unimelb.edu.au](ou.yang@unimelb.edu.au) ABSTRACT Objective We study how clinical and socioeconomic factors influence colorectal cancer (CRC) costs for patients and Medicare in Australia. The study seeks to extend the limited Australian literature on CRC costs by analysing comprehensive patient-level medical services and pharmaceutical cost data. Design, setting and participants Using the Victorian Cancer Registry, we identified all patients in Victoria who were diagnosed with CRC from 2010 to 2019 and extracted their linked 2010–2021 Medicare data. This data includes expenses from the Pharmaceutical Benefits Scheme and Medicare Benefits Schedule services. We examined variables such as disease stage, CRC type, molecular profile, metastasis status and demographics (eg, age, birth country, socioeconomic level via the SEIFA index, and native language) . We applied descriptive and log-linear multivariate regression analyses to explore patient and Medicare costs related to CRC treatment. Results Costs significantly rise with advanced cancer stages, especially on medication costs. Patients’ average out-of-pocket (OOP) expenses are roughly $A441 per year. Key cost influencers are gender, age and socioeconomic status. On average, males incur 13.5% higher annual costs, a significantly larger OOP expense, than females. Compared with patients aged 50 or below, there is a 7 . 1% cost increase for individuals aged 50–70 and an 8.8% decrease post-70, likely reflecting less intensive treatment for the elderly. Socioeconomic factors show a clear gradient. Wealthier areas experience higher costs, especially among native English speakers. Costs also vary based on cancer’s anatomical location and specific genetic mutations. Conclusion The research highlights that CRC treatment expenses for patients and Medicare differ considerably due to factors such as diagnostic stage, demographics, anatomical location of the tumour and mutations. These cost variations lead to concerns about healthcare equality and decision-making autonomy. Policymakers may need to focus on early detection, increased support for advancedstage patients, gender-sensitive healthcare, and equitable access to treatment across different socioeconomic groups. STRENGTHS AND LIMITATIONS OF THIS STUDY ⇒ The study’s inclusive approach analyses a broad demographic and multiple factors, enhancing the understanding of colorectal cancer (CRC) costs in Victoria, Australia. ⇒ Examining diverse variables, the research offers detailed insights into healthcare costs related to CRC. ⇒ Using 2010–2021 Medicare data provides a realistic view of CRC treatment costs, aiding policy relevance. ⇒ Limitations include omitting non-Medicare expenses, such as inpatient hospital costs or fees from private prov

FAQs

What was the study objective regarding CRC costs?

The study examined how clinical and socioeconomic factors influence colorectal cancer costs for both patients and Medicare in Australia.

What data sources and study population were used?

Researchers used the Victorian Cancer Registry to identify all Victoria patients diagnosed with CRC from 2010 to 2019, then extracted linked 2010–2021 Medicare data covering PBS and MBS services.

Which factors most affected costs in the results?

Costs increased significantly with advanced cancer stages, especially medication costs, and varied by gender, age, socioeconomic status, anatomical location, and genetic mutations.

Sep 21, 2026

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