OBJECTIVES: Given the recent launch of generic bortezomib IV, payers may look to increase utilization of bortezomib IV to contain costs for the treatment of adults with relapsed/refractory MM in Venezuela.  Prior to the introduction of bortezomib subcutaneous (SQ), bortezomib IV was the standard of care.  This study evaluates the fiscal impact of increased use of generic bortezomib IV on total treatment costs. METHODS: A budget impact model was developed from the Venezuelan public payer perspective. Resource costs were based on local provider interviews (2014 Venezuelan bolivars). Treatment dosing and AE rates were based on clinical trials. Inputs for market basket comparators, adverse event (AE) management and drug administration were estimated via three clinician interviews.  Generic bortezomib IV was assumed to be priced at 30% of the price of bortezomib SQ and market adoption was based on manufacturer projections, assuming equi-proportional migration from all comparators (combinations including lenalidomide, thalidomide, melphalan and dexamethasone), except bortezomib SQ, which is constant.  Cost of treatment is combined with literature-based estimates for the adult prevalence of MM (0.0018%), cases that are relapsed/ refractory (52%), and likelihood of treatment (100%) to estimate annual costs for the full population. RESULTS: The cost of treating 270 incident patients under current market shares is estimated at $27,699,084 ($102,510/patient). Assuming a 20% market share adoption of generic bortezomib IV, annual costs would increase by 26.2% to $34,944,197 ($129,323/patient), driven by the increased utilization of bortezomib IV ($20,155/patient) relative to other regimens and increases in administration ($4,562/patient) and AE costs ($2,096/patient). CONCLUSIONS: Increased utilization of generic bortezomib IV is not likely to translate into cost savings for the Venezuelan public payer given increased drug, AE and administration costs.  Another option for lowering costs may be to promote the use of newer treatment alternatives that provide both high efficacy and favorable AE and administration profiles.