OBJECTIVES: The EMPA-REG OUTCOME trial was a randomized, double-blind, placebo-controlled, cardiovascular (CV) safety trial which examined the long-term effects of empagliflozin versus placebo, in addition to standard of care, on CV morbidity and mortality in patients with T2DM and a high risk of CV events. Empagliflozin showed 38% reduction in CV death (95% CI: 0.49-0.77, p<0.001) and a 35% reduction in hospitalisation for heart failure (95% CI: 0.50-0.85, p=0.002). A post-hoc analysis showed a 39% reduction in nephropathy (95% CI: 0.53-0.70, p<0.001) and a 55% reduction in renal replacement therapy (95% CI: 0.21-0.97, p=0.04). The objective was to quantify the financial and clinical event impact of empagliflozin for treatment of patients with T2DM at increased CV risk based on the EMPA-REG OUTCOME™ study. METHODS:  A budget impact economic model was created to compare the impact of the addition of empagliflozin to standard of care. Drug use was estimated based on the drug use seen in EMPA-REG OUTCOME. Event rates were based on the event rates seen in EMPA-REG OUTCOME and event costs were based on NHS tariff costs. The model determines the incremental budget impact and potential number of events saved for empagliflozin versus usual care for treatment in high-risk patients with T2DM. RESULTS: Taking the total number of patients on the quality outcomes framework registry, it is estimated that 194,233 patients would be eligible to have empagliflozin added to their treatment regime. Over 3 years, this could result in 2,719 heart failures avoided and 5,050 lives saved with empagliflozin. An estimated £19,492,057 could be saved by the NHS budget due to the reduction in A&E admissions. CONCLUSIONS:  Cost savings could be realized when treating high CV risk diabetes patients with empagliflozin. Multiple adverse events could also be avoided, providing better outcomes to patients.