OBJECTIVES: Results from a representative German database [1] and findings from a real-life cross-sectional study [2] show an unequal distribution between basal supported oral therapy (BOT) and intensified conventional therapy (ICT) regimens in type-2-diabetics (T2D) treated with either insulin glargine (GLA) or NPH-insulin (NPH). This study assesses whether different persistence on the respective BOT can be the reason. METHODS: A Markov model was developed simulating the transition from BOT to ICT in the course of ten years in T2D treated either with GLA or NPH. Persistence data were obtained from the IMS Disease Analyzer database [3]. The model cohort consisted of 44,366 [4,5] statutorily-insured T2D starting a BOT either with GLA or NPH at a ratio of 1:1. RESULTS: The number of patients switching from BOT to ICT was continually lower in the GLA vs. NPH group (p=0.0002). Therefore, the ratio of BOT to ICT in the GLA and NPH group changed differently over time. After two years 11,840 patients (from 22,183) remained on BOT in the GLA group compared to 6,928 patients (from 22,183) in the NPH group. After 6.50 years all patients who have started with a NPH-based BOT switched to ICT. Complete transition to ICT took 1,75 years longer in the GLA group (8.25 years). The model simulation yield BOT:ICT ratios in the first quarter of year 3 for GLA (46%:54%) and for NPH (24%:76%), similar to the above mentioned findings [1;2]. CONCLUSIONS: The simulation indicates a correlation between persistence on a basal supported oral therapy and the resulting distribution of treatment regimens (BOT:ICT ratio) in T2D either treated with GLA or NPH in real-life cross-sectional studies. References: [1] ABDA claims data for ambulatory prescriptions, [2] J Med Econ 2008; 11:695-712, [3] Diabetologie und Stoffwechsel 2009; 4:1-6 [4] DDU: Gesundheitsbericht Diabetes 2008 [5] Diabetes und Stoffwechsel 2003; 12:83-94.