OBJECTIVES: The goal of the study was to evaluate the cost-utility of Insulin glargine versus NPH and premix in patients with type 1 diabetes mellitus with baseline HbA1c above 8%, applied in a Polish setting. METHODS: The method adapted was a cost-utility analysis with a 40 year time horizon. The model used in this evaluation is a Discrete Event Simulation (DES) model primarily based on the DCCT study 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. The time increment applied is in yearly increments and the model was designated to simulate a cohort of 1000 patients. Hypoglycaemia rates and rate reductions were drawn from peer-reviewed publications. Glycaemic 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. The analysis was conducted according to HTA guidelines in Poland and included also sensitivity analysis. RESULTS: When comparing insulin glargine to NPH the analyses showed that the in patients with baseline HbA1c>=10%, HbA1c>=9%, HbA1c>=8% the cost per QALY for insulin glargine vs NPH was estimated at 34,810 PLN; 26,197PLN; 38,110PLN respectively. In the same subgroups analysis for glargine vs premix in patients with baseline HbA1c>=10%, HbA1c>=9%, HbA1c>=8% cost per QALY was estimated at 33,000PLN; 29,004PLN; 47,661PLN. CONCLUSIONS:The analysis showed that glargine compared to NPH and premix is a cost-effective option for treatment of type 1 diabetes in Poland in patients with baseline HbA1c above 8%. The outcomes of the cost-utility analysis are well below the cost-effectiveness threshold in Poland (equals to 83,239PLN/QALY).