In 2020–21, $150 billion (71.6% of recurrent health spending) could be attributed to specific disease groups.

Key findings in 2020–21

Spending by disease group and specific conditions

  • Musculoskeletal disorders, such as back pain and osteoarthritis, accounted for the highest health spending among all disease groups, totalling $14.7 billion (9.8%).
  • Cancer and other neoplasms ranked as the second-highest disease group with spending of $14.6 billion.
  • Cardiovascular diseases ranked third in terms of health spending, with a total of $14.3 billion.
  • Injuries ranked fourth-highest in terms of spending ($11 billion), while Mental and substance use disorders followed closely ($10.8 billion).
  • Among specific conditions, dental caries incurred the highest spending of $5.3 billion, followed by falls-related injuries with an expenditure of $4.7 billion.

Spending by sex and age group

  • For females, Reproductive and maternal conditions, including spending on pregnancy and birth, had the highest spending ($9.0 billion), while for males Cardiovascular diseases ranked the highest ($8.0 billion).
  • The bulk of spending tends to occur later in life with a peak for both males and females in the age group 70 to 74. While for females spending between the ages of 20 to 44 was substantially higher than males, largely due to spending on Reproductive and maternal conditions.

Spending by area of expenditure

General practitioner services:

  • The highest spending on general practitioner services was for infectious diseases, amounting to $1.5 billion.
  • Mental and substance disorders followed closely, with spending of $1.2 billion.

Admitted Public hospitals:

  • Among people admitted to public hospitals, cardiovascular diseases accounted for the highest spending, at $5.4 billion.
  • Injury ranked second with a spending of $4.9 billion.
    Gastrointestinal disorders followed, with a total expenditure of $4.5 billion. 

Private hospitals:

  • In private hospitals, the disease group with the highest spending was musculoskeletal disorders, amounting to $5.5 billion.
  • Cardiovascular diseases ranked second with a spending of $2.8 billion.
    Cancer and other neoplasms accounted for $2.7 billion in spending. 

Pharmaceutical Benefits Scheme (PBS):

  • Expenditure on medicines under the PBS was highest for cancer and other neoplasms, totalling $4.1 billion (24.1% of all PBS spending).
  • Cardiovascular diseases accounted for $2.0 billion (12.0%).
  • Musculoskeletal disorders followed with $1.7 billion (10.2%).

Pathology services:

  • Infectious diseases was the disease group with the highest spending on pathology services (MBS pathology claims) at $1.0 billion (27.8% of all pathology spending). 

Spending on COVID–19

In 2020–21, $2.6 billion was spent on COVID–19. The highest COVID–19 expenditure areas were public hospital outpatient services with $1.7 billion, pathology services with $649 million (65% of pathology spending for all infectious diseases), and general practitioner services with $201 million. 

When looking at spending by sex and age, females aged 30–34 had the highest expenditure of $126.5 million, while for males the highest expenditure was for those aged 35–39 with $112.2 million. 

During 2020–21 treatment for COVID–19 was mostly undertaken in the hospital setting. There was an absence of PBS expenditure for the treatment of COVID–19 during 2020–21 as there were no therapeutics approved by Therapeutics Goods Administration, or available for consideration by the Pharmaceutical Benefits Advisory Committee, for the treatment of mild-moderate COVID–19.

Key comparisons over time

Estimated spending by disease increased by $11.7 billion (in current prices) to $150.1 billion in 2020–21, up from $138.4 billion in 2019–20. This was an overall growth of 8.5% in nominal terms (current prices).

Overall rank of disease groups

  • Musculoskeletal disorders, Cardiovascular diseases and Cancers and other neoplasms were the top 3 disease groups in terms of spending throughout the decade from 2011–12 to 2020–21, accounting for just under one-third of all disease spending each year.
  • Spending on Cancer and other neoplasms doubled from $7.3 billion in 2011–12 to $14.6 billion in 2020–21 (moved from rank 3 to rank 2 in terms of spending).
  • Musculoskeletal disorders ranked the highest in terms of spending for 4 of the past 5 years, the exception was in 2019–20.
  • In 2016–17 Infectious diseases was the fourth highest disease group, primarily due to a large increase in spending on PBS medications for Infectious diseases in that year.

Spending by sex and age group

  • Across the decade from 2011–12 to 2020–21 spending peaked for both males and females in the 65–74 age groups.
  • For Infectious diseases, since 2018–19, the 1–4 year age group had the highest share of spending for both males and females.
  • Within the hospital setting spending on cancers peaked between 60–74 year old males and females with clear increases in spending starting from around age 30–34 years onwards.

Spending by area of expenditure

Spending on Infectious diseases across the decade from 2011–12 to 2020–21 has shown the most variation. The impact of COVID–19, resulted in an increase in spending in 2019–20 and 2020–21 particularly in the areas of pathology and non-admitted services in public hospitals. Earlier in the decade, in 2016–17, there was an increase in spending of medicines on the PBS used to treat infectious diseases in that year, namely the inclusion of ledipasvir+sofosbuvir, which is primarily used to treat hepatitis C.

$5.3 billion was spent on Dental caries and $4.7 billion was spent on injuries where the external cause was Falls
For people admitted to public hospitals, cardiovascular diseases accounts for the highest spending, followed by injury and gastrointestinal disorders