OBJECTIVES: Recent publications have demonstrated equal efficacy of capecitabine and fluorouracil/leucovorin in combination with oxaliplatin in the adjuvant treatment of stage III colon cancer. It is stated that CAPOX and FOLFOX can be used interchangeably. METHODS: A cost-minimization analysis was performed using a Markov model, a two-year time horizon and a hospital perspective. Assuming equal efficacy of CAPOX and FOLFOX, transition probabilities were based on the MOSAIC trial (Andre et al., 2004 and 2009).  Dutch real-world population-based treatment and follow-up cost were calculated using a representative sample of 102 patients treated with oxaliplatin for stage III colon cancer in 19 hospitals in the Netherlands.  Resource use was collected from the first administration of adjuvant chemotherapy until disease progression (or end of follow-up). Costs of drug acquisition, drug administration, patient monitoring, and adverse events were considered and reported in euro 2009. RESULTS: In Dutch practice, the median time on adjuvant treatment was 24 weeks for both CAPOX and FOLFOX, as recommended in the guidelines. Mean total costs were € 19,373 for CAPOX and € 31,324 for FOLFOX, resulting in a significant overall cost savings of € 11,951 for CAPOX compared with FOLFOX.  Main savings resulted from administration costs (€ 8,460), due to increased hospital admissions in the FOLFOX treatment as the administration of fluorouracil involves a 48-hour continuous infusion. Other savings were obtained from acquisition costs (€ 2181) and costs of managing adverse events (€ 1427). Monitoring costs were comparable in CAPOX and FOLFOX. Probabilistic sensitivity analysis confirmed the robustness of the results. CONCLUSIONS: CAPOX is cost-saving in comparison with FOLFOX for the adjuvant treatment of stage III colon cancer in a real-world setting in the Netherlands. Considering the high incidence of colon cancer in the Netherlands, substantial overall savings can be realized by routine use of CAPOX in this indication.