OBJECTIVE: The ability to perceive vibration (vibration detection) has been shown to be a good predictor of long-term complications among patients with diabetic peripheral neuropathy (DPN). The aim of the study was to estimate the predicted complications and costs for the NHS associated with reduced vibration detection. METHODS: A Markov model of DPN progression was constructed for a hypothetical cohort of people with DPN. The model was run over a ten-year period using Monte Carlo simulations to estimate disease progression, predicted costs, life-years and quality-adjusted life-years (QALYs) according to vibration detection levels. Rates of foot ulceration and amputation, the probability of healing, and health state utility scores were identified by undertaking a focused literature search. The cost data used in the model were derived from a concurrent cost of illness study. RESULTS: Discounted over ten-years, the average individual with reduced vibration detection incurs approximately 3.3 times more direct medical costs for foot ulcers and amputations (£1531 vs. £457), yields 0.19 fewer QALYs, and lives for approximately 2 months shorter than an average individual with normal vibration detection. The long-term complications of DPN (foot ulcers and amputations) experienced by the population with reduced vibration detection will cost the NHS approximately £292m (discounted) over the next ten years. CONCLUSIONS: Effective treatment of foot ulceration and amputation is time-consuming and expensive. If at-risk individuals with reduced vibration detection could be identified and targeted for intervention, valuable Health care resources could be saved and improved health outcomes should result. For example, if all individuals in the UK with diabetes and reduced vibration detection were identified and their risk of ulceration and amputation reduced to levels experienced by those with normal vibration detection, this could save the NHS up to £204m, and save 29,000 life-years and 36,000 QALYs (discounted) over the next ten years.