OBJECTIVES: To assess the cost-effectivness of lenalidomide in treatment of the second and third lines of multiple myeloma in the Russian Federation. METHODS: We developed an economic model of multiple myeloma disease to calculate the cost of diagnosis and treatment of second and third-line therapy of lenalidomide and bortezomib. The efficacy of drugs (time to progression- TTP) was obtained from clinical trials: MM - 009/-010 for lenalidomide; APEX for bortezomib. TTP for lenalidomide was 21.2 months and for bortezomib - 16.4 months. Medical care costs were estimated from the standard of multiple myeloma treatment, which was developed and published by Ministry of public health. RESULTS: A CER of  lenalidomide in the second line therapy was 468,110,84 RUB (11,529,82 €) which is lower then use of  bortezomib in the second line  therapy 605 118,89 RUB (14,904,4 €). CONCLUSIONS: Application of lenalidomide in second-line therapy of multiple myeloma is dominated alternative of treatment.