OBJECTIVE: To evaluate, in the Swedish setting, the cost-effectiveness of raising low high-density lipoprotein-cholesterol (HDL-c) with Niaspan® on top of statin-based therapy, in type 2 diabetes (T2D) patients with persistently low HDL-c levels. METHODS: We used a simulation model made of 2 decision analytic sub-models. The first sub-model (second order Monte-carlo simulations) generated patient's cohort and simulated lipid changes after treatment. Baseline cohort characteristics were taken from a Pan-European Survey on HDL-c prevalence (Swedish diabetic sub-group). Niaspan® treatment effects were taken from the ARBITER II study. Patients with low HDL-c (<1.03 mmol/L) on statin treatment received either add-on Niaspan® (1g/day) or continued statin alone. The second sub-model (Markov) calculated the risk of coronary heart disease events based on Framingham risk formulae. Direct medical costs (SEK) were accounted from a third-party payer perspective. Annual discount rates of 3% were applied to costs and clinical benefits. Simulations were run to capture patient lifetimes. RESULTS: Niaspan® + statin was associated with an increase in discounted life expectancy (0.20 years) compared to statin alone. Direct medical costs were on average SEK34,320 higher in the Niaspan® + statin group leading to an Incremental Cost-Effectiveness Ratio of SEK169,696 per Life Year Gained (ICER ® to statin treatment increases life expectancy and is highly cost-effective compared to statin monotherapy in T2D patients with dyslipidemia and persistently low HDL-c.