Oral capecitabine is highly active drug with favourable safety in adjuvant and metastatic colorectal cancer. Adjuvant capecitabine is at least as effective as 5-fluorouracil/leucovorin (5-FU/LV), with significant superiority in relapse-free survival and a trend towards improved disease-free and overall survival. We assessed the cost-effectiveness of adjuvant capecitabine from payer (health insurance companies in Czech Republic) and societal perspectives (including indirect costs). We used clinical trial data and published sources to estimate incremental direct and societal costs and gains in quality-adjusted life months (QALMs). Acquisition costs were higher for capecitabine (99,601 CZK) than 5-FU/LV (8,586 CZK), but higher 5-FU/LV administration costs, cost of adverse events and hospitalisation costs resulted in comparable direct costs for capecitabine and 5-FU/LV. Administration costs were significantly higher for 5-FU/LV (by 59,500 CZK), as well as cost of therapy for adverse effects (by 11,467 CZK). Societal costs, including patient travel/time costs, were lower for capecitabine group vs 5-FU/LV (cost savings 19,307 CZK), with lifetime gain in QALMs of 9 months. Medical resource utilisation (direct costs) are slightly higher with capecitabine vs 5-FU/LV in Czech Republic (by 18,687). The use of a societal perspective to measure the time and travel costs associated with the treatments illustrates the advantage of oral over infusion treatment. Counting together (direct and indirect costs) capecitabin is slightly less costly alternative (by 624 CZK) in comparison with 5-FU/LV. Capecitabine is also projected to increase life expectancy vs 5-FU/LV. And from the point of view of incremental cost-utility analysis capecitabin vs. 5-FU/LV can be considered to be dominant (cost-saving and more-effective) therapy. This pharmacoeconomic analysis supports the place of therapy of capecitabine vs. 5-FU/LV in the adjuvant treatment of colon cancer in Czech Republic.