OBJECTIVES: The aim of the study was to evaluate the cost-utility of Insulin glargine versus premix in insulin naïve and non insulin naïve patients with type 2 diabetes applied in a Polish setting. METHODS: Cost-utility analysis from public payer perspective was conducted with a 40 years time horizon. The model used in this evaluation is a DES model which has the ability to assess the economic impact and health consequences outlined as the development of co-morbidities of a reduction in hypoglycemia, an improvement in glycaemia or both of these at the same time. A cohort of 1000 patients was generated in the model. Hypoglycemia rates and rate reductions were drawn from peer-reviewed publications. Glycaemia control has been incorporated into the model using results from The Health Improvement Network (THIN) database. Polish costs were applied in the model and only direct medical costs were considered in the analysis. Sensitivity analysis was performed. RESULTS: When comparing insulin glargine to premix (using base case results for background hypoglycemia events) the analyses showed that the cost per QALY was estimated at 57,678 PLN for insulin naïve patients and 44,244 PLN for non-insulin naïve patients. The total estimated discounted costs over a lifetime for insulin naïve patients were for glargine 23,158,693 PLN and for premix 16,307,845 PLN, total estimated discounted QALYs were for glargine 6,121 and for premix 6,002.  In non-insulin naive patients costs were for glargine 26,871,051 PLN and for premix 18,813,440 PLN and QALYs were 9,855 and  9,747 for insulin glargine and premix respectively. CONCLUSIONS:The results showed that glargine compared to premix represents good value for money. Using the cost-effectiveness threshold in Poland (which is equal to 83,239 PLN/QALY) insulin glargine should be regarded as a cost-effective option for treatment of patients with type 2 diabetes in Poland.