OBJECTIVES: FOLFOX4 has been the chemotherapy of choice for patients with stage III colon cancer. Recently, the international NO16968 study reported results confirming the efficacy of XELOX in this setting, and evidence suggests that both regimens have at least equivalent efficacy. Therefore, medical and societal resource utilization are important factors for providers, patients and payers. The objective of this analysis was to compare total costs required to treat an average aCC patient with either XELOX or FOLFOX4 in Switzerland. METHODS: In the absence of a direct comparison, detailed medical resource utilization (MRU) data collected for XELOX from study NO16,968 (aCC) and for FOLFOX4 from study NO16,966 (metastatic colorectal cancer) were analyzed. The FOLFOX4 regimens are identical in both indications; therefore MRU data from NO16,966 were considered valid proxies. In addition to direct MRU (chemotherapy, hospitalizations due to adverse events (AEs), ambulatory encounters, AE medication and central venous access (CVA) placements), patient time and travel costs for hospitalizations, ambulatory encounters and drug administration were estimated. Unit costs were derived from official tariffs (Spezialitätenliste, Tarmed 2010 for drug costs and physician services), official statistics (hospital cost, mean hourly salary) and tax guidelines (travel costs). Total costs while on treatment (24 weeks) for an average patient with aCC were compared. RESULTS: On average, XELOX saved CHF 11,471 per patient vs. FOLFOX4. CHF 8883 resulted from savings in direct costs, mainly driven by savings in drug administration (CHF 9312) and CVA-placements (CHF 1730). Savings in patient time and travel costs amounted to CHF 2588. CONCLUSIONS: XELOX appears to be cost-saving vs. FOLFOX4 in aCC from both a Swiss health care system and the societal perspective, assuming equivalent efficacy for the two regimens. Considering the high incidence of colon cancer in Switzerland, substantial overall savings may be realized by routine use of XELOX in this indication.