OBJECTIVES: Cost comparison of insulin glargine (IG) versus insulin detemir (ID) in a basal-bolus regime with mealtime insulin aspart in type 2 diabetes patients (T2D) in Germany. METHODS: Clinical data were taken from a randomised controlled trial [1]. IG was administered once daily, ID once or twice daily.  Mean daily insulin doses (basal:bolus) were 0.59 and 0.32 U/kg for IG and 0.82 and 0.36 U/kg for ID. Glycaemic control, weight gain, adverse events and risk of hypoglycaemia were similar in both groups after 1 year (non inferiority trial) so a cost minimisation analysis was undertaken. Costs were calculated from the perspective of the statutory health insurance (SHI) using official 2008 prices. It was assumed that a new needle, lancet and test strip were used at the time of each injection. RESULTS: The annual single costs per patient for needles were €393 for IG and €449 for ID. The costs of blood glucose test strips and lancets were €1125 for IG and €1286 for ID. The overall costs of basal-bolus insulin were €1,607 for IG and €2144 for ID. The total annual costs per patient was €3126 for IG compared with €3879 for ID, translating into a 19% annual cost saving of €753/patient in favour of IG. Sensitivity analyses confirmed the robustness of the results. CONCLUSIONS: IG and ID basal-bolus regimes have comparative safety and efficacy outcomes, based on [1], IG however may represent a significantly more cost saving option for T2D patients in Germany requiring basal-bolus insulin analogue therapy with potential cost savings of €753€ (19%) compared to ID. REFERENCE: [1] Hollander P et al.. A 52-week, multinational, open-label, parallel-group, noninferiority, treat-to-target trial comparing insulin detemir with insulin glargine in a basal-bolus regimen with mealtime insulin aspart in patients with type 2 diabetes. Clinical Therapeutics 2008;30:1976-87. Study supported by sanofi-aventis