OBJECTIVES: To investigate the health economics outcomes of insulin glargine (GLA) usage in comparison with insulin NPH (NPH) in diabetes type-2 (DM 2) in real practice in the Russian Federation. METHODS: Observational study has been performed in 92 centers in 35 cities of Russia. Two goups of patients (1st- 100 pts received GLA o.d, 2d - 100 pts - NPH bid) were analized for 6-months period. Group GLA had been switched previously from NPH. Efficacy was evaluated according to HbA1ñ level as target ≤7%. The performed CEA analysis included direct costs of medications based on average dosages, hospitalizations, days of disability and hypoglycemias. RESULTS: The duration of DM 2 was equal in both groups - above 9 years. In GLA - 87% pts and in 92% NPH pts had high HbA1c at baseline, and 45% and 82% (p<0.001) after the end of the study accordingly. Average daily doses of GLA at the end of the study were 32.9 UI and for NPH - 34,1 UI. Hospitalization rate was higher in NPH than in GLA (1,44 vs 0,73 day/patient, p<0.01), disability days (1,37 vs 0,82 days, p<0.05). The CER was better for GLA vs NPH - €314 RUR and 780 RUR accordingly. Increase of additional cost was higher for NPH (23.71%) than for GLA (7.78%) per patient. CONCLUSIONS: GLA in DM 2 is more cost-effective in comparison with NPH due to a better efficacy and safety.