an economic assessment of analogue basalbolus insulin versus human basalbolus insulin in subjects with type 1 diabetes in the uk background a recent study demonstrated that treatment of type 1 diabetes with an analogue basalbolus insulin regimen was associated with improved glycaemic control hba1c 022 points p 0001 reduced risk of hypoglycaemic events 21 p 0036 and reduction in body mass index 030 kgm2 p 0001 compared to a human basalbolus regimen after 18 weeksmethods a published and validated computer simulation model was used to project longterm economic and clinical outcomes in a simulated cohort of type 1 diabetes patients treated with either insulin detemir plus insulin aspart analogue or neutral protamine hagedorn plus human soluble insulin human in a uk setting probabilities of complications and hba1cdependent adjustments were derived from major clinical and epidemiological studies complication and treatment costs were projected over patient lifetimes from a national health service perspective costs and clinical benefits were discounted at 35 annuallyresults qualityadjusted life expectancy qale was 066 qualityadjusted life years qaly higher in the analogue insulin versus the human insulin group mean sd 765 009 versus 699 008 direct lifetime costs were 1654 pounds greater with analogue versus human insulin treatment 40876 pounds 1119 versus 39222 pounds 1141 producing an incremental cost effectiveness ratio icer of 2500 pounds per qaly gained sensitivity analyses showed the results were robust under a range of plausible scenariosconclusions treatment with analogue insulin was associated with a decreased incidence of longterm complications and improved qale but slightly higher treatment costs compared to human insulin therapy analogue insulin treatment had an icer within the range generally considered to represent good value for money in the uk