OBJECTIVES:  Multiple myeloma (MM) is a malignancy of plasma cells that results in an overproduction of light and heavy chain monoclonal immunoglobulins. Multiple myeloma imposes a significant economic and humanistic  burden  on patients and society. The present study is aimed to assess the burden of multiple myeloma in epidemiologic and economic terms. METHODS:  A retrospective, naturalistic longitudinal study on the occurrence, outcomes and cost of multiple myeloma using an administrative database was performed. We selected residents of a North-eastern Region of Italy, who had the multiple myeloma first hospital admission during the period 2001-2005, and we followed them up until December 31, 2006, death or transfers. Direct medical costs were quantified in the perspective of the Regional Health Service. RESULTS: out of a population if 1.2 million inhabitants, we enrolled 517 patients (52% female) leading to a crude incidence of  8.6/100.000 person-years.  During the period of observation, 364 (70.4%) subjects died. Total health care costs per patients over the maximum of follow-up were €78,020 for the subjects younger than 70 years old and €23,096 in older group. CONCLUSIONS: The overall cost of MM is substantial, particularly in the first year after diagnosis and for hospital care. The natural history of the disease requires a great absorption of resources in the early phases after diagnosis and in the late stages of the disease. Multiple myeloma imposes a significant epidemiologic and economic burden to the healthcare- system and  society.METHODS ARESULTS CONCLUSIONS T