OBJECTIVES Multiple myeloma (MM) is an incurable disease with an incidence of 4-7 new cases by 100.000 people. In the setting of the study, 28% of the yearly 25 news cases of MM are candidates to autologous stem cell transplant (ASCT). Because of the lack of real-world economic studies, authors sought to describe the cost per quality-adjusted-life-year (QALY) of the MM treatment in a group of transplanted patients. METHODS An observational retrospective study was performed and included detailed clinical data from a transplanted cohort of patients with MM. All patients received bortezomib based treatments. Costs were evaluated from the payer’s perspective and included total drug costs and hospital admission costs. QALYs values were obtained from the CEA Registry of Tufts University. Four health states were considered: complete response (CR), partial response, stability and progressive disease. Time between state transitions was used to calculate QALYs for each patient. RESULTS The study included 17 patients with a mean age of 61,2 years; 12 of them (Group 1) were followed during 2,77±0,24 years and 5 (Group 2) during 1,6±0,19 years. Global complete response rate one year after ASCT was 8/17 (47%) and dropped to 5/12 (41,6%) at two years. For the whole cohort the median of QALY’s cost was 56.198€ (IQ range 36.391-70.339). For patients with CR one year after ASCT, the median of QALY’s cost was 46.358€ (IQ range 36.299-67.537). For all other patients the median of QALY’s cost was 56.676€ (IQ range 39.114-73.613). For Group 1 patients, the median of QALY’s cost was 51.278€ (IQ range 36.345-73.613). CONCLUSIONS These results reveal that the actual costs of MM treatment using protocols that include bortezomib are above the 30.000-50.000€ threshold generally admitted in cost-effectiveness studies.