OBJECTIVES: This study compared number of patient visits and out-of-pocket costs for multiple myeloma (MM) patients treated with bortezomib (BOR; Velcade®; IV administration), lenalidomide (LEN; Revlimid®; oral), thalidomide (THAL; Thalomid®; oral), or other unspecified chemotherapies/radiation therapy.  METHODS: Patients aged >=18 yrs, diagnosed with MM between January 1, 2005 and September 30, 2007, and treated with BOR, LEN, THAL, or other unspecified chemotherapies/radiation therapy were identified using claims data from a large US commercial health plan (~14 million members). Treatment episodes (each course of therapy) were identified from patient records. Health-care utilization (number of ambulatory patient visits) and inflation-adjusted patient out-of-pocket costs, including co-pays and deductibles, were examined for 1 yr from the beginning of each treatment episode. Multivariate regression analyses were performed to control for patient characteristics, comorbidities, and line of treatment. RESULTS: A total of 2642 treatment episodes for 1900 patients were identified. Most episodes were “other chemotherapy/radiation therapy” (n=1759), followed by THAL (n=549), BOR (n=244) and LEN (n=90). There were no between-group differences in inpatient or emergency room visits. Patients treated with BOR appeared to have more ambulatory visits compared with patients treated with LEN (77 versus 61; p<0.05); however, this difference was not significant after multivariate analysis (66 versus 57; p>0.05). The total adjusted patient out-of-pocket costs were significantly less for patients treated with BOR ($3504) than for those treated with THAL ($4443, p<0.05) or LEN ($4766, p<0.05). These differences were greatest for Medicare patients, with the adjusted patient costs of THAL ($8,824) and LEN ($12,568) respectively, nearly 2 and 3 times greater than the adjusted costs of BOR ($4,395). CONCLUSIONS: There was no significant advantage in terms of fewer patient visits with the oral drugs (THAL, LEN) over BOR. Direct out-of-pocket costs were significantly higher for patients treated with THAL and LEN compared with BOR, especially for Medicare patients.