OBJECTIVES: Treatment options for patients with relapsed multiple myeloma (MM) have recently seen the addition of a number of new therapies. Some of these may be used in combination, but there is no clear standard of care and the relative cost-effectiveness of the new therapies or combinations thereof remains largely untested. Pegylated liposomal doxorubicin in combination with botrezomib represents a new alternative whose clinical performance appears to give better patient outcomes (both overall survival (OS) and progression-free survival (PFS) than bortezomib alone. To complete a technology appraisal within the Scottish healthcare setting, a cost-effectiveness model was developed comparing the combination therapy against bortezomib monotherapy as well as against high-dose dexamethasone monotherapy. METHODS: The model used clinical outcomes data from the licensing trials of the combination therapy (DOXIL MMY-301 study) as well as the licensing trial for bortezomib monotherapy (APEX study). Patient utilities prior to and after progression were sourced from a published cost-effectiveness study. A ten-year timeframe was assumed and available clinical data for PFS and OS were extended using Weibull regression methods. RESULTS: The results from our base case analysis suggest that the combination therapy is cost-effective compared to bortezomib monotherapy (ICER £17,303/QALY) as well as versus high-dose dexamethasone therapy (ICER £27,880/QALY). Incorporation of further clinical OS and PFS statistics from a recent data update resulted in a slight increase in ICERs, however these remained cost-effective. CONCLUSIONS: The model suggests that the combination therapy would be a cost-effective addition to the Scottish treatment paradigm.