OBJECTIVES: To analyze cost-effectiveness of bortezomib versus dexamethasone for recurrent or treatment-resistant multiple myeloma in Russian health care system. METHODS: The study was performed from the Russian reimbursement system point of view. An economic model prepared for the submission to National Institute of Health and Clinical Excellence was used as a framework. Effect of studied drugs was measured in life-years gained. The effectiveness was estimated on the basis of APEX study results and complemented with prognosis of long-term outcomes. Direct medical costs for medication were included into the model, registered prices were taken from the Russian reimbursement list while dose regimen and number of treatment courses were considered to be equal to those used in APEX study. The incremental cost-effectiveness ratio (CER) was calculated. RESULTS: The incremental effectiveness of bortezomib versus dexamethasone was estimated as 2,371–2,739 life-years gained (the interval includes minimal and maximal values identified by different approaches to long-term outcomes projection). The incremental cost was 1 822 774,00 rubles (about 70 thousands USD). The incremental CER was 67,510,148 — 792,510,43 rubles (25-29 thousands USD) per life-year gained. CONCLUSION: The incremental CER for bortezomib is comparable with other expensive drugs included into the reimbursement system. Further studies are needed to assess cost-effectiveness of bortezomib vs other therapeutic strategies used for resistant and recurrent multiple myeloma and to evaluate effectiveness in medical practice.