OBJECTIVES: Multiple Myeloma (MM) is a hematological malignancy characterized by skeletal destruction, renal failure, anemia and hypercalcemia. Only 4 to 5% of the patients experience a survival of more than 10 years. The incidence reported worldwide was 114,251 new cases per year, with 1.5 cases per 100,000 residents. Given its low incidence, MM is considered orphan disease. The objective of the study is to estimate the budget impact to the Mexican public healthcare system when introducing Carfilzomib in the treatment of patients with refractory and relapsed MM who have received at least two previous treatments, including bortezomib and an immunomodulating agent. METHODS: A budget impact analysis was conducted using a 3 health states Markov model (progression-free, post-progression and death) with monthly cycle length. The budget impact of Carfilzomib was compared to the current standard treatment in Mexico (high-dose dexamethasone), while low-dose dexamethasone was assumed after progression, according to Mexican KOLs advice. The eligible population was based on the incidence rate (3/100,000) for MM in Mexico and an estimate of the percentage of relapsed and refractory patients from the literature. Only direct medical costs were accounted for drugs, procedures, laboratory tests and adverse events management. Costs were expressed in US dollars (Exchange rate $15.16/USD)  RESULTS: After introducing Carfilzomib, incremental budget impact in the first 5 years wasestimated to have an average budget increase of .0033%.   CONCLUSIONS: Assuming an increasing uptake of 5% per year, introducing Carfilzomib to the Mexican public healthcare system would on average increase budget by 0.0033%, being affordable in terms of funding and representing an effective and safe new therapeutic option for patients with relapsed and refractory MM.