OBJECTIVES: Several studies have evaluated the ICER of CSII vs. MDI over a patients’ lifetime. However, decision makers are also concerned with shorter time-horizons. As such, the annualized incremental cost and consequences of CSII vs. MDI may be informative to this audience. METHODS: An economic model was developed using Excel spreadsheet. Deterministic data derived from various sources including ICES Diabetes Atlas, Statistics Canada Population and published literature was used to determine the annualized costs and consequences of CSII vs. MDI in the Province of Ontario. RESULTS: Overall the use of CSII for all type 1 diabetic patients (T1DM) age 18-64 in the base case analysis would result in savings associated with the event reductions of $77,885,000 per year (95%CI: 55,920,148-123,835,211). Assuming all T1DM patients switched to CSII, annual resource saving include: 63 fewer AMI (95%CI:20.8-233.0), 23 fewer major amputations (95%CI:6.4-133.9), 14 fewer blindness cases (95%CI:3.6–224.5), 411 fewer dialysis years (range 329.2-493.8), and 140 fewer hypoglycaemia related hospitalizations (range 112.3-168.5). Additional investments in CSII would result in a net expenditure of $4,724,000. However, extensive sensitivity analysis shows that there is a potential cost saving of $26,689,000-$41,225,000 for the province in direct medical cost assuming all 48,000 T1DM patients adopted this technology. CONCLUSIONS: Use of CSII has demonstrated improved glycaemic control compared to MDI.  Additional health benefits including reductions in AMI, amputations, cataract surgery, dialysis rates, and hypoglycaemia related hospitalization could potentially save the health care system both costs and precious resources. Sensitivity analyses suggest that under the most favourable conditions, adoption of CSII would be a dominant strategy (saving $41,000,000 / annum in the steady state). This analysis underestimates the CSII benefits by ignoring smaller benefits including minor amputations, costs associated with gangrene. Also, the effects on patient’s HR-QoL and other socio-economic benefits related to lost productivity, has not been calculated.