OBJECTIVES To evaluate the cost of using the dipeptidyl peptidase-4 inhibitor (DPP4i), saxagliptin, compared to sitagliptin and linagliptin, when used as triple therapy in combination with metformin and sulphonylurea (met+SU) for the treatment of patients with type 2 diabetes mellitus (T2DM) who are inadequately controlled on met+SU alone. METHODS Bucher adjusted indirect treatment comparisons (ITCs) were performed with regards to the key T2DM outcomes of HbA1c, weight and hypoglycaemia compared to sitagliptin and linagliptin. The ITCs found no statistically significant differences between saxagliptin compared to either sitagliptin or linagliptin in terms of effectiveness (as measured by Hb1Ac change from baseline), and saxagliptin was found to be at least as safe as the other therapies. Therefore, a cost-minimisation analysis over a 1-year time horizon was developed from a UK healthcare perspective. Drug costs were considered in the model, sourced from the British National Formulary (BNF; September 2013). The application of an annual discount rate of 3.5% and use of a longer time horizon (up to 5 years) were explored in a scenario analysis. RESULTS Saxagliptin was associated with a yearly cost of £410.80 per patient. The yearly cost per patient for sitagliptin was £432.38, and the yearly cost per patient for linagliptin was also £432.38, based on drug costs. Therefore, saxagliptin has similar costs compared to the other DPP4i’s. Applying the annual discount rate and using a longer time horizon, saxagliptin was associated with cost-savings of £97.43 per patient over 5 years compared to both sitagliptin and linagliptin. CONCLUSIONS Saxagliptin as triple therapy in combination with met+SU was shown to be a cost-saving treatment option from a UK healthcare perspective for patients with T2DM who are inadequately controlled on met+SU alone. The cost-saving per patient over 5 years was modest, although this may be important in a large patient population.