OBJECTIVES: In the Czech Republic there are three modern molecules available for the treatment of multiple myeloma: bortezomib, thalidomide and lenalidomide. In order to better understand this evolving specific market, analysis of consumption trends has been conducted with emphasis on the molecules’ mutual influence.  METHODS: Time-consumption curves of bortezomib, lenalidomide and thalidomide since 2009, based on the economic data of the General Health Insurance Company of the Czech Republic, were analyzed. While there was reimbursement for thalidomide in the first line treatment and bortezomib in the second line in 2009, we focused on and evaluated the impact of the launch of lenalidomide in 2009 (as a second line treatment). We also investigated the extension of reimbursement of bortezomib for the use in the first line in 2010.  RESULTS: The introduction of lenalidomide (2009) led to a rapid decline in thalidomide consumption within the next year, in contrast to bortezomib, the consumption of which appeared unaffected. Furthermore, also the consumption of thalidomide decreased profoundly following the extension of reimbursement conditions of bortezomib (2010). The overall relative reduction in thalidomide consumption observed within the two years between 2009 and 2011 was 70%.  CONCLUSIONS: The presented retrospective analysis shows that the impact of myeloma treatment on payers’ financial budgets has increased nearly 3-times in the last four years. The extension of reimbursement of bortezomib had a clear impact on the consumption of thalidomide, which was its supposed comparator in the first line therapy. However, it appears that even though the introduction of lenalidomide did also significantly affect the consumption of thalidomid, it had no apparent impact on the use of bortezomib.