OBJECTIVES: To evaluate the cost of care of patients with symptomatic multiple myeloma (MM) in France. METHODS: Oncologists, haematologists and internists completed case report forms for patients who, in the 3 months before study initiation, either progressed after receiving specific treatment regimens (those most commonly prescribed) or received best supportive care (BSC) and died. Data on patient characteristics, treatment outcomes, costs and healthcare resource utilisation were collected retrospectively from the beginning of the last completed treatment line onwards for those receiving: second-line lenalidomide or bortezomib; third-line lenalidomide, bortezomib, pomalidomide or bendamustine; fourth-line lenalidomide, pomalidomide or bendamustine; any regimen in fifth line or greater; BSC only. The costs of drugs and resources (e.g. hospitalisation and laboratory tests) were estimated using standardised schedules and databases (e.g. Public Medicines Data, Health Insurance and General Nomenclature of Professional Acts). RESULTS: Physicians (n=76) provided data on patients receiving active treatment (n=455) and BSC (n=47). The mean (standard deviation [SD]) total cost per line (second to fourth line) for lenalidomide‑based treatment regimens was €44,271 (27,281) (mean duration of treatment [DoT] (SD): 12.4 (7.3) months). For bortezomib-based regimens, the mean (SD) total cost per line (second to third line) was €35,289 (15,000) (mean [SD] DoT: 8.3 [4.3] months). Pomalidomide-based regimens were associated with the highest mean (SD) total cost per line (third to fourth line): €64,816 (42,750) (mean [SD] DoT, 7.4 [4.9] months). Bendamustine-based regimens had the lowest mean cost (SD) per line (third to fourth line): €14,267 (14,435) (mean [SD] DoT, 6.8 [6.5] months). The mean (SD) total cost for BSC was €1,949 (SD 3916) for those who progressed following active treatment discontinuation and €3,823 (SD 4,448) for those without progression before death. CONCLUSIONS: Management of patients with relapsed MM in France is expensive and costs vary according to treatment regimen and DoT.