OBJECTIVES: Quick release (QR)-bromocriptine mesylate is a new treatment for type 2 diabetes (T2DM) that has been shown to reduce HbA1c and cardiovascular (CV)-related hospitalizations over one year. The objective of this study was to estimate the economic impact of (QR)-bromocriptine versus other oral antidiabetic drugs as add-on therapy for patients who failed initial treatment. METHODS: A decision-analysis model was designed to compare outcomes among QR-bromocriptine, pioglitazone, rosiglitazone, and sitagliptin over one year when used as add-on therapy. For each drug, changes in HbA1c levels were derived from product labels and used to derive the expected number of hospitalizations for diabetes-related complications based on published equations linking HbA1c levels to hospitalizations. Rates of CV-related events (major adverse cardiac events, congestive heart failure, angina, and revascularization) were extracted from clinical trial reports of antidiabetic drugs in T2DM and were expressed on an annualized basis. Hospital costs per admission were estimated from the Healthcare Cost & Utilization Project, while drug costs were based on wholesale acquisition cost. A payer perspective was assumed and direct medical costs were expressed in 2009 USD. RESULTS: Patients treated with QR-bromocriptine had lower diabetes-related hospitalization costs ($2,017) than those receiving rosiglitazone ($2,038), and higher costs compared to pioglitazone ($1,928) and sitagliptin ($1,989).  Patients receiving QR-bromocriptine had lower CV-related hospitalization costs ($426) than those treated pioglitazone, sitagliptin, or rosiglitazone ($523, $708, and $729, respectively). Annual drug costs were lower for patients receiving QR-bromocriptine ($2,122) compared to pioglitazone ($2,605) and sitagliptin ($2,282) and higher than for those receiving rosiglitazone ($1,977). Overall one-year costs were estimated to be $4,565, $5,056, $4,979, and $4,745 for QR-bromocriptine, pioglitazone, sitagliptin, and rosiglitazone respectively. CONCLUSIONS: Our findings suggest that, over one year, T2DM patients treated with QR-bromocriptine as an add-on therapy are expected to have lower costs than those receiving pioglitazone, sitagliptin, and rosiglitazone.