Introduction: Sodium glucose co-transporter 2 inhibitors (SGLT2i), glucagon-like peptide-1 receptor agonists (GLP-1RA), and the non-steroidal mineralocorticoid receptor antagonist finerenone all reduce cardiovascular events and mortality in patients with type 2 diabetes. However, the lifetime benefits of combination therapy with all three medications are not known. Aim: To estimate lifetime gains in cardiovascular event-free and overall survival with combination SGLT2i, GLP-1RA, and finerenone in patients with type 2 diabetes and albuminuria. Methods: We used individual participant data from the CANVAS and CREDENCE trials and trial-level data from 8 GLP-1RA trials and 2 finerenone trials (FIDELIO and FIGARO) to estimate the relative effects of combination therapy on cardiovascular and mortality outcomes. Using nonparametric age-based methods, we applied combined treatment effects to placebo treated patients with urinary albumin:creatinine ratio ≥30 mg/g in the pooled CANVAS and CREDENCE trials. Results: The aggregate hazard ratio comparing combination therapy versus conventional standard of care for major adverse cardiovascular events (MACE; nonfatal myocardial infarction, nonfatal stroke or cardiovascular death) was 0.65 (95% CI 0.55-0.76) (Figure). For a 50-year-old, estimated event-free survival from MACE was 18.0 years with placebo and 21.2 years with combination therapy (3.2 years gained, 95% CI 2.1-4.2; Figure). Estimated gains in survival free from hospitalised heart failure, cardiovascular death, and all-cause death with combination therapy in a 50-year-old person were 3.3 (95% CI 2.5-4.1), 2.2 (95% CI 1.2-3.1), and 2.5 years (95% CI 1.4-3.5) respectively, with benefits evident across all ages studied. Conclusions: Combination treatment with SGLT2i, GLP-1RA and finerenone in patients with type 2 diabetes and albuminuria is projected to afford clinically important gains in cardiovascular event-free and overall survival.