OBJECTIVES: Ixazomib is an oral proteasome inhibitor used to treat multiple myeloma in combination with lenalidomide and dexamethasone, in patients who have received at least one prior treatment. This study aims to perform a budget impact analysis to quantify the economic consequences of the introduction of ixazomib in combination with lenalidomide and dexamethasone as a therapeutic alternative in the Brazilian Private Healthcare system. METHODS: A budget impact model was developed in which the current treatment pathways (without ixazomib) were compared to a future scenario (including ixazomib). Number of eligible patients was estimated using incidence data from published literature. Current treatment options include doublet or triplet regimen with bortezomib, daratumumab, carfilzomib, elotuzumab, lenalidomide or dexamethasone. Treatment administration and dosing, medical resources and adverse events rates were based on relevant clinical trials and assumptions were validated with specialists. The prices are in Brazilian Reais (BRL) and were obtained from CMED (Drug Market Regulation Chamber) Price List. RESULTS: It was estimated that the introduction of the regimen with ixazomib, lenalidomide and dexamethasone would result in a lower budget impact in comparison to the scenario without these therapies: there is an economy of more than BRL 205 million in five years. In addition, this economy of resources occurs in every year from its incorporation. CONCLUSIONS: Although the costs associated with treating MMRR with triple therapies generate high costs for the whole system, results of the budget impact analysis suggest that the introduction of ixazomib is a cost-saving option from the Private Healthcare System perspective in Brazil, supported by both robust clinical evidence on progression-free survival, safety profile and oral administration, and economically feasible with it's introduction as a therapeutic alternative associated to a lower budget impact to the system.