OBJECTIVES: Cost comparison between different basal insulin regimens (Glargine vs. Detemir vs. NPH-insulin) in diabetic patients in Germany under real-life conditions. METHODS: The analysis is based on IMS LRx-database (2011). This representative patient tracking tool covers nearly 60 million insurants and includes more than 500 million drug prescriptions per year (including consumables) Patients with at least two prescriptions of basal insulin (Glargine, Detemir or NPH-insulin) in 2011 (January – December) and at least one prescription of any type in 2010 and 2012 were considered eligible. Costs included basal and bolus insulin, oral antidiabetic drugs, test strips, needles and lancets and were estimated by ex pharmacy prices (Lauer Taxe) minus legally defined rebates according to §130 a of social security code (SGB V). RESULTS: A total of 542.438 patients were allocated to either Glargine (207.506 patients) or Detemir (90.671 patients) or NPH (244.261 patients). The mean annual treatment costs per patient are 1.211 € (Glargine), 1.224 € (NPH insulin) and 1.572 € (Detemir). A breakdown at the level of different sick funds shows a similar pattern of annual treatment costs per patient of the three basal insulin regimens. The acquisition costs of basal insulin is considerably higher for Glargine (380 €) and Detemir (448 €) compared to NPH-Insulin (253 €). The cost of bolus insulin is lower in the Glargine group (305 €) compared to NPH-insulin (419 €) and Detemir (493 €). Costs of consumables (test strips, needles, lancets) are lowest in the in the Glargine group (395 €) due fewer insulin applications compared to Detemir (509 €) and NPH insulin (461 €.) CONCLUSIONS: Mean annual treatment costs are lowest with Glargine followed by NPH-insulin, whereas Detemir based regimens are 30% more expensive under real life conditions. The results are in line with previous cost analyses in diabetic patients in Germany [1-3]