OBJECTIVES: A cross-sectional retrospective, prevalence-based study was designed to measure costs and QoL associated with MM management at different disease phases in a societal perspective. METHODS:  A snapshot questionnaire was administered to 236 subjects in 5 Italian hematological centers. Health-related QoL was measured using the EORTC QLQ-C30 and its MM specific module MY24, administered to 199 patients at enrolment). Four disease-phases were considered in a distribution that reflects real clinical practice: asymptomatic, “watch-and-wait” (16%); symptomatic, receiving an autotransplant (12%); symptomatic, receiving drugs (45%); and  plateau/remission (including best supportive care) (27%). Costs were identified over 1 year of disease management with regard to: drugs, visits, laboratory tests, hospital admissions, support devices, home assistance, travel, and reduced productivity of patients and caregivers. Costs for working days lost were derived according to the human capital method. RESULTS: The average costs  per subject per year were €20,695 while direct health-care costs were €16,717 and direct non-health care costs were €447; indirect costs (productivity loss) were €3,531 per subject per year. The average direct health care costs per subject per year were: €660; €53,020; €18,892; €6,319 for asymptomatic, autotransplanted, receiving drugs and plateau/remission respectively. The groups with the highest resource utilization were the autotransplanted and those receiving drugs. Regarding QoL, our sample of 199 patients recorded a 60.93 Global Health Score in QLQ-C30 (asymptomatic: 71.05; autotransplanted: 57.41; receiving drugs: 49.25; Plateau/remission: 72.02). CONCLUSIONS:  The main resource utilization comes from direct medical costs. MM treatment strategy has changed dramatically in the past years. In particular, transplant and pharmacological treatments represent the most relevant costs, although counterbalanced by the highly increased clinical outcomes reported in literature (Kumar,Blood,2007). The QoL analysis showed the impact of maintaining patients in the plateau/remission phase, which ensures that their QoL and particularly the global health score is comparable with asymptomatic.