OBJECTIVES To evaluate the cost-effectiveness of canagliflozin, an active inhibitor of sodium glucose co-transporter – 2 (SGLT2) in dual therapy as add-on to metformin compared to sitagliptin and glimepiride. Canagliflozin in clinical trial results showed effective glucose reduction, along with other benefits in diabetes treatment including weight loss and SBP reduction. Cost effectiveness analyses were conducted in the Polish setting from a public perspective in accordance with guidelines of Polish HTA Agency (PolAHTA). METHODS The IMS CORE Diabetes Model was used to evaluate the cost-effectiveness of canagliflozin versus the aforementioned comparators using Polish-specific data, where available. Direct costs were reported in Polish zloty and an annual discount rate of 5% and 3.5% were applied on costs and effects respectively. RESULTS In dual therapy as add-on to metformin, canagliflozin 100 mg dominates sitagliptin with average cost savings of 2 811 zł and an average QALY gain of 0.06, canagliflozin 300 mg is cost effective option in comparison to sitagliptin with an incremental cost effectiveness ratio (ICER) of 45 008 zł per QALY and QALY gain of 0.09. As add-on to metformin canagliflozin is a cost effectiveness option in comparison with glimepiride with ICER of 28 454 zł and 73 102 zł, QALY gain 0,112 QALY and 0,140 QALY for canagliflozin 100 mg and 300 mg respectively.All results are below defined in Polish reimbursement act cost-effectiveness threshold. CONCLUSIONS These results suggest that adding Canagliflozin to metformin versus sitagliptin or glimepiride in patients inadequately controlled with metformin would be a more efficient use of healthcare resources in the Polish setting.