OBJECTIVES: Insulin analogues offer certain advantages over regular human insulin. Our objective was to establish the incremental cost-effectiveness ratio (ICER) of insulin analogues compared with human insulin, with multiple daily injections (MID) in adult patients with type 1 diabetes mellitus (DM1) in Colombia. METHODS: We designed a Markov model of annual cycles, time horizon of up to 55 years, from a third-party payer perspective (only direct medical costs for the Colombian healthcare system) and applying discount rate of 3.5% both for costs and outcomes. Quality-adjusted life years (QALYs), taken from published literature, were used as a measure of effectiveness with a threshold of three times the per capita gross domestic product (GDP), approximately € 17,550. The comparison between analog and human insulin was performed separately for short and long term. The costs were in Colombian pesos (1 € = COP 2.660), and were built through base cases designed by interdisciplinary expert panels, with drug prices and costs of interventions or adverse events were estimated using official tariff manuals and databases. Univariate and probabilistic sensitivity analysis were performed. RESULTS: Despite certain clinical advantages, insulin analogues gain, on average, very few QALYs (from 0.02 to 0.1 depending on scenarios). With this result, the average ICER for short-term insulins would be € 78,900; while long duration insulin analogues have an ICER of € 94,550. Results were highly sensitive to price of medication, as well as to disutility or costs of hypoglycemic events. CONCLUSIONS: Given the assumptions and limitations of our model, insulin analogues would not be considered cost-effective within the Colombian healthcare system compared with multiple daily injections for adult patients with DM1.