OBJECTIVES: To develop an economic evaluation to compare individually and vial-packaged strips for glucose monitoring. METHODS: A model was developed to compare the costs and effects (hypoglycemic events, nosocomial infections and use of strips) of using individual vs. vial-packaged strips (IP vs. VP) including three different settings which represents the pathway of a diabetic patient: home, hospital and primary care. For each alternative (IP and VP), a simulated cohort of 1000 patients went through the model accounting for costs and effects, and the results were expressed as hypoglycemic events, nosocomial infection events, use/waste of strips and incremental cost-effectiveness ratio Three different scenarios were modelled where different rates of hypoglycemic events, waste of strips and nosocomial infections were used. Sources of parameters is wide and uncertainty is high. Due to the lack of information about certain parameters, a group of assumptions were made. Uncertainty was tested using one-way sensitivity analysis and probabilistic sensitivity analysis. Cost-effectiveness acceptability curve with a threshold of 25.000€/QALY was drawn. Probabilistic results were depicted using a Cost-effectiveness plane. RESULTS: Globally, IP saved money (9.4 € per patient) and get more QALYs (0.0005 per patient) (DOMINANCE) with no reduction in nosocomial events, 25% less hypoglycemic events and 26% reduction in the use of strips. We found that the differences in costs between options are quite similar between Home, PC and Hospitalization (€4,227.14, €4,155.26 and €4,932.88 respectively) whereas Home module accounted for more QALYs than PC and Hospitalization (0.36, 0.14 and 0.15 QALYs respectively). Differences remained in the three scenarios. Sensitivity analysis did not offer any change in deterministic results. CONCLUSIONS: Under the assumption of wrong measurements due to bad storage and manipulation, the use of individual packaged strips could avoid between 12% and 43% of hypoglycemic events and save between 4% and 8 % of total costs.