OBJECTIVES: The Dutch government introduced in 2002 policy regulations to provide additional financing for expensive inpatient pharmaceuticals. In 2006 the policy was revised after signals of ‘zipcode prescribing’ of trastuzumab (Herceptin®). The aim of this study is to examine national and regional utilisation of the expensive drug bortezomib (Velcade®) and investigate whether accessibility issues exist in Dutch daily practice. In 2004 bortezomib received market approval and in 2006 it was added to the expensive drug list for the indication of multiple myeloma. METHODS: Our longitudinal study investigated sales data (excluding trial use) from 2004 to 2009 and compared these figures with an estimation of the prevalence of patients with multiple myeloma. Prevalence was estimated from incidence figures of the Netherlands Comprehensive Cancer Centres. We calculated the percentage of patients treated with bortezomib at both national and regional level. In addition, interviews with haematologists were conducted investigating potential prescription barriers for bortezomib. RESULTS: At the national level, utilisation gradually increased from treating 2% of the patients to 17%, indicating a long adjustment period. Furthermore, underutilisation might still be present since utilisation is lower than 27%, which is the estimated percentage of eligible patients by the professional group. In 2009, regional utilisation ranged from 12% to 24%. Even though interviews revealed that haematologists were aware of the high treatment costs, they did not experience absolute prescription barriers.   CONCLUSIONS: Utilisation of bortezomib is increasing and accessibility has improved in the Netherlands. However, the trend indicates a long adjustment period. Although haematologists did not experience absolute barriers, the indication of underutilisation and residual regional differences might point towards accessibility issues in the Netherlands, despite the policy revisions.