Objective: The EMPA-REG OUTCOME Trial demonstrated that Empagliflozin (EMPA) significantly reduced risk of hospitalization for heart failure by 35% in adult patients with type 2 diabetes (T2D) and established CV disease (CVD). Currently, no data is available on impact of EMPA on healthcare resource use (HCRU) in routine clinical care in East Asia. Methods: In an analysis on administrative data from Japan, South Korea and Taiwan, we identified 28,712 pairs of 1:1 propensity score (PS)-matched patients ≥18 years with T2D initiating EMPA or a DPP4 inhibitor (DPP-4i) with mean follow up of 5.7-6.8 months. We evaluated outcomes of all-cause of hospitalization, ER visits, outpatient visits. Pooled risk ratio (RR) or hazard ratios (HR) with 95% confidence intervals (CI) were computed using meta-analysis techniques. Subgroup analyses in patients with (N=9,485 PS-matched pairs) and without CVD (N=19,220) were performed. Results: Risk of all-cause of hospitalization (RR = 0.73 (95%CI: 0.67, 0.79)), ER visit (RR=0.88 (0.83, 0.94)), outpatient visit (RR=0.96 (0.96, 0.97)) and first hospitalization (HR = 0.77 (0.73, 0.81)) were lower in EMPA group compared to DPP-4i group. Reductions of HCRU were also comparable in patients with and without baseline CVD. Conclusion: Our results showed reductions in HCRU across all types of care, including inpatient care, in patients with and without CVD initiating EMPA compared to DPP-4i in routine clinical care observed shortly after treatment initiation.