OBJECTIVES: Vildagliptin is a DPP-4 inhibitor available in Colombia for the treatment of diabetes mellitus as monotherapy or in combination with metformin, sulfonylureas, or insulin. Our aim was to determine the cost-effectiveness of the addition of vildagliptin to metformin, or sulfonylureas for the management of type 2 diabetes in Colombia. METHODS: We developed a hybrid decision Markov model to simulate the level of glycemic control and the health states associated with macrovascular complications (myocardial infarction, disabling stroke, and heart failure), nephropathy and death in a hypothetic cohort of patients with type 2 diabetes. Transition probabilities and utilities were derived from published trials and validated with local clinical experts. Costs were calculated based on resource use from local clinical guidelines and databases from the Ministry of Health and private institutions. The base case was developed based on the demographic characteristics of patients with type 2 diabetes in Colombia with a mean age of 59 years. The analysis was performed from the payer perspective for a time horizon of 20 years. Multivariate sensitivity analysis was performed. RESULTS: Our results show that the addition of vildagliptine to metformine yielded an incremental effectiveness of 0.83 QALY’s over the 20 years of this cohort when compared to metformine alone. The addition of vildagliptine to metformine + glimepiride combination yielded an minor increase in QALY’s of only 0.27. Incremental cost for the addition of vildagliptine to metformine was $COP 3,626,000 ($1,900 USD). The incremental cost of the addition of vildagliptine to the combination of metformine was $COP 9,713,169 ($5,100 USD).  The ICER for the addition of vildagliptine to metformine was $COP 4,358,350 ($2,500 USD) and to metformine + glimepiride was $ COP 35,697,647 ($18,700 USD). CONCLUSIONS: The addition of vildagliptine to metformine and metformine+glimepiride is a cost-effective alternative for the treatment of diabetes type 2 in Colombia.