OBJECTIVES: Brazil ministry of health guidance for diabetes management allows for an insulin needle to be reused 8 times. Reuse has been associated with lipohypertrophy. Additionally, diabetes patients with lipohypertrophy require higher doses of insulin. This analysis demonstrates potential cost savings from syringe reuse reduction in Brazil. METHODS: A budget impact model was created to demonstrate the relationship between lower syringe reuse and lipohypertrophy rates. It was assumed 90% of patients use syringes in Brazil. An international survey suggests the lipohypertrophy rate is 48%. Another study showed increasing reuse correlates to a higher ratio of lipohypertrophy presence. With estimates including additional insulin requirements for lipohypertrophy, cost of insulin, and annual cost and volume of syringes, the difference between insulin wasted from lipohypertrophy and the cost associated with reducing reuse rate was calculated. RESULTS: The estimated insulin injecting population with lipohypertrophy using syringes in Brazil is 691,200. If these patients require 15 units more insulin/day and the cost/unit is $0.03, then the cost of excess insulin is $113.5 million/yr. The difference in rate of lipohypertrophy between reusing 8x (rate of 5.5) and reusing 4x (rate of 2.2) is a factor of 2.5. Based on estimated cost, volume, and currently allowed reuse rate, Brazil spends approximately $22.8 million on insulin syringes. If a reuse rate of 4x was implemented ($45.6 million), Brazil could anticipate a lipohypertrophy reduction of 28.8%, and a $68.1 million decrease in excess insulin. The savings on excess insulin and the incremental investment in syringes ($22.8 million) results in a total savings of $45.3 million/yr. CONCLUSIONS: The current acceptable reuse rate in Brazil, 8x, may be driving increased diabetes management costs. Best practice advocates single use. However, if Brazil cuts their reuse guidance in half, they can save $45.3 million/yr from reduced insulin waste.