OBJECTIVE: To systematically review the cost-effectiveness of insulin degludec (IDeg) in the treatment of type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM). METHODS: A systematic review of literatures was conducted via PubMed, EMBase, The Cochrane Library, CNKI, Wanfang Data, VIP, IDF, ISPOR, ADA and EASD from the inception to January 2016, to identify pharmacoeconomics evaluation literatures and non-economic studies related to IDeg in the treatment of T1DM and T2DM, compared with other basic insulin [insulin glargine (IGlar), insulin detemir (IDet), neutral protamine hagedom insulin (NPH)]. RESULTS: A total of 8 studies were included and all of them were carried out in European countries. In the short-term (one year), IDeg was more economical when compared with other basic insulin in patients with T1DM. The studies related to the long-term treatment of T1DM demonstrated different conclusions, but most of studies came to a conclusion that IDeg had good cost-effectiveness. For patients with T2DM, all of the studies demonstrated that IDeg was cost-effectiveness compared with IGlar. CONCLUSIONS: Compared with other basic insulin, IDeg can improve therapeutic efficacy and the quality of life, as well as reduce the cost of ADR as hypoglycaemia. IDeg is a dominant or cost-effective treatment opinion.