OBJECTIVES: CANA and DAPA are sodium glucose co-transporter 2 inhibitors indicated for the treatment of adults with T2DM as monotherapy and as add-on combination therapy with other antihyperglycemic agents. The objective of this analysis was to evaluate the cost-effectiveness of using CANA 300mg versus using DAPA 10mg in dual therapy (with MET background) in patients with inadequate A1C control. METHODS: A validated health economics model, Economic and Health Outcomes (ECHO)–T2DM, was used to estimate 30-year outcomes associated with using each treatment in patients as an add-on to MET monotherapy. Treatment effects for A1C, weight and the probability of hypoglycemia were obtained from a Bayesian Network Meta-Analysis (NMA) of 52 (+/-4) week trials of subjects inadequately controlled on MET monotherapy. For parameters unavailable in the NMA (i.e., SBP, LDL, HDL and rates of AEs), values were obtained from a post-hoc analysis of pooled data from two trials of subjects receiving CANA and MET. In the model, treatment was intensified when A1C exceeded 7.5%, first by adding basal insulin and subsequently by adding prandial insulin. Utility decrements and U.S. costs associated with key macrovascular and microvascular heath states and AEs were sourced from the literature. All costs and benefits were discounted at 3%. RESULTS: CANA dominated DAPA; CANA was associated with both cost savings ($3,204) and more Quality Adjusted Life Years (0.22). The reductions in the relative risks of microvascular (up to 4.4%) and macrovascular events (up to 1.7%) as well as a delay in the use of insulin are the key drivers. CONCLUSIONS: This simulation suggests that CANA will not only produce cost-savings, but also result in QALY gains versus DAPA in the treatment of patients inadequately controlled on MET in the US.