OBJECTIVES: In patients with type-1 diabetes, poor glycemic control is associated with an increased risk of complications. A recent clinical study provided evidence that basal/bolus treatment with insulin detemir+insulin aspart (IDet/IAsp) improved HbA1c (0.22%-points lower after 18 weeks), reduced the risk of hypoglycemic events (by 21%), and decreased body mass index (BMI) (-0.3 kg.m-2) in comparison to neutral protamine Hagedorn insulin+human soluble insulin (NPH/HSI). The aim of this study was to project the long-term clinical and cost outcomes associated with IDet/IAsp versus NPH/HSI basal/bolus therapy in the German setting based on these findings. METHODS: A published, validated and peer-reviewed model that combines Markov sub-models and Monte Carlo simulation was used to simulate the progression of diabetes and its complications (cardiovascular disease, neuropathy, renal and eye disease). Transition probabilities and HbA1c-dependent adjustments were derived from published sources. Baseline cohort characteristics and treatment effect data were based on the clinical study. Direct costs were retrieved from published sources and projected over patient lifetimes from a German National Healthcare perspective. Costs and clinical benefits were discounted at 3.5% annually. RESULTS: IDet/IAsp treatment was associated with fewer diabetes-related complications, improved life expectancy (0.23 life years gained) and quality-adjusted life expectancy (0.21 QALYs gained) compared to NPH/HSI. Mean total lifetime costs were €3,165 per patient higher with IDet/IAsp, leading to incremental cost-effectiveness ratios (ICERs) of €13,761 per life year and €15,071 per QALY gained. CONCLUSIONS: Short-term clinical benefits in glycemic control, hypoglycemic event rates and BMI associated with IDet/IAsp basal/bolus therapy were projected to lead to fewer complications, improved life expectancy and quality-adjusted life expectancy compared to NPH/HSI. This resulted in ICERs for IDet/IAsp versus NPH/HSI in the range considered to represent good value for money.