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Objective To evaluate the cost-utility of insulin degludec (IDeg) versus insulin glargine U100 (IGlar U100) and insulin glargine U300 (IGlar U300) in Chinese patients with type 2 diabetes. Methods From the perspective of health system, based on the IQVIA CORE diabetes model, the long-term medical costs and health outcomes of treatment with IDeg, IGlar U100 and IGlar U300 were calculated and an incremental cost-effectiveness analysis was performed. Health outcomes included life years and quality adjusted life year (QALY), and medical costs included drug cost, disease management cost and complication treatment cost. The price of insulin adopted the price of national volume-based procurement. The simulation model runs for 30 years at a discount rate of 5%. The robustness of the results was evaluated by one-way sensitivity analysis and probabilistic sensitivity analysis. Results Compared with the IGlar U100 group, the quality of life in IDeg group was gained by 0.060 QALY, the direct medical cost was increased by RMB 158 Yuan, and the ICER was RMB 2 639 Yuan/QALY. Compared with the IGlar U300 group, the quality of life in IDeg group was gained by 0.085 QALY, the direct medical cost was reduced by RMB 1 402 Yuan. Sensitivity analysis verified the robustness of the results. Conclusions Compared with IGlar U100 and IGlar U300, IDeg was likely to be a cost-effective treatment in Chinese patients with type 2 diabetes mellitus. [ABSTRACT FROM AUTHOR]