Bortezomib also known as Velcade is indicated as a parenteral agent in the treatment of multiple myeloma. In noncomparative trials in multiple myeloma patient’s early treatment was associated with a greater rate of success. Treatment with Bortezomib-based regimens was associated with improvements in health-related quality of life. Orthopaedic surgery for spinal cord compression in patients with multiple myeloma was generally predicted to be cost saving, relative to not having surgery, over the medium to long term in modelled cost analyses from a healthcare payer perspective in the UK and US. The initial cost of surgery was high, but the difference in costs between patients undergoing or not undergoing surgery was predicted to decline over time, as savings were realised from the decrease in the number of thrombocytopaenic episodes requiring treatment in patients who underwent surgery. Available pharmacoeconomic data from several countries including the Cochin Cancer Research Centre in Kerala State, India despite inherent limitations, support the use of Bortezomib in the first line treatment of multiple myeloma.