OBJECTIVES: To provide an estimate of the clinical and economic outcomes of long-term use of either all analog (insulin detemir (IDet) + aspart (IAsp)) or all human (NPH + human soluble insulin (HSI)) basal bolus regimens among type 1 diabetes patients. METHODS: Comparative efficacy data was obtained from a recent 18-week randomized controlled trial (n=595) which demonstrated statistically significant benefits in glycemic control (HbA1c: -0.22%, p<0.001; PPG excursions: p<0.001), risk for hypoglycemia (all: 21% lower, p=0.036; 26.9 vs. 34.6 events per patient year; nocturnal: 55% lower, p<0.001), and weight gain (-1.01 kg, p<0.001) in favor of analogs. Subjects were 63% male, aged 39.1 years, and had a mean baseline HbA1c of 8.38% (duration of diabetes: 15.3 (10.3) years). A published, peer-reviewed and validated model of type 1 diabetes was used to make long-term projections, using second order Monte Carlo methodology, to evaluate life expectancy, quality-adjusted life expectancy, cumulative incidence of complications, and direct medical costs (pharmacy plus complication costs). Base case time horizon was 35 years. Future costs and clinical benefits were discounted at 3% annually. Sensitivity analyses were performed. RESULTS: Treatment with IDet+IAsp was projected to increase life expectancy (0.168 years), QALE (0.698 QALYs), and reduce cumulative incidences of diabetes-related comorbidities (cardiovascular, renal, and ocular disease) versus NPH+HSI. Direct medical costs were higher in the IDet+IAsp group, leading to an ICER of $14,974 per QALY gained. One-way sensitivity analysis of pharmacy costs (±15%), discount rate (0-6%), complication costs, and duration of treatment effect on HbA1c (<5 years) support the robustness of these findings. CONCLUSION: Patients with type 1 diabetes who require basal bolus therapy may benefit from analog insulin treatment in comparison to human insulin. Long-term therapy was projected to improve life expectancy, quality-adjusted life expectancy, and complication rates, representing good value for money according to commonly supported standards.