OBJECTIVES: The aim of this analysis was to project the long-term clinical and economic outcomes associated with therapy conversion to insulin detemir fromNeutral Protamine Hagedorn (NPH) insulin in patients with type 2 diabetes in the German setting. METHODS: A previously published and validated computer simulation model of diabetes was used to make long-term projections of clinical and cost outcomes based on patient characteristics and treatment effects from a sub-analysis of the PREDICTIVE study. Data from PREDICTIVE indicated that therapy conversion from NPH insulin to insulin detemir was associated with significant improvements in glycemic control (HbA1c 0.6 %) and reduced weight gain (body mass index 0.382 kg/m2). Based on these clinical findings, the computer simulation model was used to estimate life-expectancy, quality-adjusted life expectancy and costs from a third party health care payer perspective. Future costs and clinical benefits were discounted at 5% per annum. RESULTS: Conversion to insulin detemir was projected to improve life expectancy by approximately 0.13 years compared to NPH (7.08±0.13 versus 6.95±0.12 years) and quality-adjusted life expectancy by 0.28 quality-adjusted life years (QALYs) (4.51±0.09 versus 4.23±0.08 QALYs). Direct medical costs over patient lifetimes were projected to be marginally lower in patients receiving insulin detemir compared to NPH (€54,575±1,842 versus €54,640±1,739, difference €65 per patient). Pharmacy costs were higher with insulin detemir (€14,129 versus €12,230, difference €1,899) but were more than offset by cost savings due to complications avoided (complication costs €38,246 versus €40,242, difference €1,996). CONCLUSION: This modeling study, based on a German sub-analysis of PREDICTIVE, suggests that therapy conversion from NPH to insulin detemir is likely to be associated with long-term clinical benefits and may well be cost saving in type 2 diabetes patients in the German setting.