OBJECTIVE: The increasing prevalence of diabetes (DM) in China is generating a large economic burden for health care systems. This study aims at reviewing cost analysis and cost-effectiveness data on the long-acting basal insulin analogue, insulin glargine and provides experience from other countries concerning GLAR economic aspects. METHODS: A systematic literature review of GLAR versus NPH economic studies through the public and internal database was performed. Original papers and conference abstracts providing cost comparison or cost-effectiveness results were included. RESULTS: Ten studies (one manuscript and nine abstracts) met the inclusion criteria. Five were cost analysis studies comparing resource used in one year in insulin users or patients transferred to GLAR. Costs were not completely detailed since most studies were reported in abstracts. Five studies from Spain, Norway, Australia, and Switzerland were cost-effectiveness evaluations, based on Markov model simulation that allow to project long term costs and effects (9 to 30 years) on short-term and long-term complications due to DM. Three studies were performed in type-1 and two in type-2 patients. HbA1c results obtained from short-term comparative clinical trials were the main driver of projected differences in long-term complications and associated costs. The quality of model-based studies is not clear due to the limited information from abstracts. CONCLUSIONS: Results of short-term cost-analysis suggest that the cost of diabetes could be decreased with GLAR by reducing the cost of hypoglycemia treatment and hospitalization as compared to NPH. Results from long-term analysis indicate that GLAR is a cost-effective alternative to NPH in patients with type-1 and type-2 diabetes in countries where the analyses were performed. The economic impact of insulin glargine use in China remains to be evaluated.