OBJECTIVES: A recent European-based clinical trial showed that basal/bolus treatment of 747 subjects with type 1 diabetes with insulin detemir+human soluble insulin (IDet/HSI) significantly improved HbA1c (0.11%-points lower after 26 weeks) and body weight (-0.61 kg) compared to a regimen of neutral protamine hagedorm insulin+human soluble insulin (NPH/HSI). No significant changes in hypoglycemic event rates were observed. The aim of this analysis was to estimate the long-term clinical and cost outcomes associated with IDet/HSI and NPH/HSI regimens based on German cost data. METHODS: A validated, peer-reviewed computer simulation model was used to project the incidence of complications, life expectancy, quality-adjusted life expectancy and costs over patient lifetimes. The model simulated the progression of diabetes and its complications (cardiovascular disease, neuropathy, renal and eye disease). Transition probabilities and risk adjustments were derived from published clinical and epidemiological studies. Baseline cohort characteristics and treatment effects were taken from the 26-week clinical study. Direct costs of diabetes complications and treatments were retrieved from published sources and accounted from a German Healthcare payer perspective. An annual discount rate of 3.5% was applied to costs and clinical benefits. RESULTS: Long-term basal/bolus therapy with IDet/HSI was projected to decrease the incidence of diabetes-related complications, improve life expectancy (0.13 life years gained) and quality-adjusted life expectancy (0.09 QALYs gained) compared to NPH/HSI. Lower complication costs in the IDet/HSI arm partially offset the increased costs of treatment. Mean total lifetime costs were €1,798 per patient higher with IDet/HSI than with NPH/HSI, leading to incremental cost-effectiveness ratios of €13,831 per life year gained and €19,978 per QALY gained. CONCLUSIONS: Based on short-term clinical trial findings, IDet/HSI was projected to reduce the incidence of long-term complications, improve life expectancy and quality-adjusted life expectancy, and can be considered to represent good value for money by German and international standards.