OBJECTIVES: Previous studies have shown that for patients with type 2 diabetes, self monitoring of blood glucose (SMBG) can improve glycemic control (with HbA1c improvements of 0.3-0.6%, depending on treatment received). This in turn, can reduce risks of disease complications. Because monitoring supplies can have high acquisition costs, country-specific evaluations of SMBG cost-effectiveness are needed. The aim of this analysis was to estimate, within France, the cost-effectiveness of using SMBG. METHODS: A validated, published model for type 2 diabetes (The CORE Diabetes Model) was used to project improvements in quality-adjusted life expectancy (QALE), long-term costs and cost-effectiveness of SMBG. A series of Markov models simulated the progression of diabetes-related complications (cardiovascular, neuropathy, renal and eye disease). Transition probabilities and HbA1c-dependent adjustments came from major epidemiological studies. Costs of complications were derived from published sources. From the government payer perspective, direct costs of diabetes complications and of SMBG were projected over patient lifetimes. Outcomes were discounted at 3% annually. RESULTS: Depending on type of treatment (diet/exercise, oral medications, or insulin), greater glycemic control with SMBG improved (discounted) QALE by 0.10 to 0.15 QALYs and increased total costs by €323 to €703 per patient. The resulting incremental cost-effectiveness ratios ranged from €3220 to €7276 per QALY gained, and were well within current willingness-to-pay limits. SMBG was most cost-effective in the sub-group of patients being treated with oral antidiabetic medication. CONCLUSIONS: Within the three treatment regimens examined, the addition of SMBG was associated with increased glycemic control and with improved clinical and economic long-term outcomes. The incremental cost-effectiveness ratios were of magnitudes typically considered to indicate good value for money within the French health care setting. Additional comparative studies are needed to further assess Utilities and other standard outcomes associated with SMBG in patients with type 2 diabetes.