OBJECTIVES: In Hungary the standard therapy in the adjuvant treatment of stage III colon cancer is the DeGramont-protocol, a combination of 5-fluorouracil and leucovorin. In the MOSAIC trial the addition of oxaliplatin (FOLFOX4) improved the efficacy of the standard therapy in this patient group. The aim of our study was to evaluate the cost-effectiveness of FOLFOX4 compared to standard therapy in Hungary. METHODS: The cost-utility analysis of the FOLFOX4 therapy was based on the MOSAIC trial. The efficacy data of the MOSAIC trial was extrapolated for lifetime, while utilities values were incorporated from published sources. Age and gender specific general mortality rates and utilities were derived from epidemiology data of the Hungarian population and published utilities based on the EQ-5D questionnaire. The analysis was accomplished from payer perspective. Thus, only direct medical costs were taken into account. Resource use was based on Hungarian treatment patterns and unit costs. Costs and outcomes were discounted at 5%. Cost-effectiveness was measured in terms of incremental cost per quality-adjusted life year saved (QALY), incremental cost per disease-free years (DFY) and incremental cost per life-years saved (LYS). One-way sensitivity analysis was employed. RESULTS: Compared to DeGramont therapy, FOLFOX4 resulted in an additional 0.455 QALY, 0.531 LYS, 0.958 DFY and HUF 1,310,064 (5,240€) per patient. The cost for one QALY was HUF 2,880,342 (11,521€), while for one DFS and LYS was HUF 1,367,712 (5,471€) and HUF 2,468,660 (9875€), respectively. The results were most sensitive to discount rate, general population data and the cost of chemotherapy. CONCLUSION: Based on the possible thresholds in Hungary, and the €20,000/QALY quoted in countries of the EU zone, FOLFOX4 is a cost-effective strategy in Hungary for the postoperative adjuvant treatment of patients with stage III colon cancer compared to the DeGramont protocol.