OBJECTIVES: Evaluate the cost-utility (CUA) of vildagliptin or sulphonylurea as add on to metformin treatment for DMII patients for the Greek NHS METHODS: A validated patient level simulation model was used based on UKPDS risk equations (Clarke 2004) to estimate long run micro/macro-vascular complications and mortality over a lifetime horizon. During each cycle a patient can experience different complications: ischemic heart disease, myocardial infarction (MI), chronic heart failure, renal failure, stroke, amputation, blindness in one eye. The outcomes assessment criteria were Quality Adjusted Life Years (QALYs) and Life Years Gained (LYG). Quality of life decrements were derived from literature. Discount rates of 3.5% were set for both costs and outcomes and univariate sensitive analysis was conducted. Drug costs were based on Greek published list prices 2012, while complication cost was obtained from International literature. RESULTS: The mean number of QALYs per patient in the lifetime horizon was 6.24 in the vildagliptin&metformin group and 6.16 in sulphonylurea&metformin group, resulting in 0.08 QALYs in favor of vildagliptin&metformin group.  Total costs per patient were €7,848 in vildagliptin&metformin group and €7,572 for sulphonylurea&metformin, resulting in €276 cost difference for the latter.  The incremental cost effectiveness ratio (ICER) for vildagliptin&metformin versus sulfonylurea&metformin is estimated at €3.371 per QALY for a lifetime horizon.  Regarding the analysis on life years gained, vildagliptin&metformin group had on average 8,01 LYG and sulphonylurea&metformin 7,93, leading to a difference of 0.08 years in favour of vildagliptin&metformin.  ICER for vildagliptin&metformin versus sulfonylurea&metformin is estimated at €3.424 per life years gained.    CONCLUSIONS: For the Greek NHS adding Vildagliptin to Metformin is projected to be highly cost-effective for patients with type 2 diabetes who are not at HbA1C goal on Metformin compared to adding SU to Metformin.  The price difference of the two comparators is bridged when complications’ cost is included in the analysis.