AIM:To compare XELOX and FOLFOX4 as colon cancer adjuvant chemotherapy based on MOSAIC and No.16968 trails from Chinese cost-effectiveness perspective.METHODS:A decision-analytic Markov model was developed to compare the FOLFOX4 and XELOX regimens based MOSAIC and No.16968 trial.Five states were included in our Markov model:well(state 1),minor toxicity(state 2),major toxicity(state 3),quitting adjuvant chemotherapy(state 4),and death due to adjuvant chemotherapy(state 5).Transitions among the 5 states were assumed to be Markovian.Costs were calculated from the perspective of the Chinese health-care payer.The utility data were taken from published studies.Sensitivity analyses were used to explore the impact of uncertainty factors in this cost-effectiveness analysis.RESULTS:Total direct costs of FOLFOX4 and XELOX per patient were$19884.96±4280.30 and$18113.25±3122.20,respectively.The total fees related to adverse events per patient during the entire treatment were$204.75±16.80 for the XELOX group,and$873.72±27.60 for the FOLFOX4 group,and the costs for travel and absenteeism per patient were$18495.00for the XELOX group and$21,352.68 for the FOLFOX4group.The base-case analysis showed that FOLFOX4was estimated to produce an additional 0.06 in quality adjusted life years(QALYs)at an additional cost of$3950.47 when compared to the XELOX regimen over the model time horizon.The cost per QALY gained was$8047.30 in the XELOX group,which was$900.98 less than in the FOLFOX4 group($8948.28).The one way sensitivity analysis demonstrated that the utility for the well state and minor toxicity state greatly influenced the incremental cost-effectiveness ratio of FOLFOX4.CONCLUSION:In term of cost-comparison,XELOX is expected to dominate FOLFOX4 regimes;Therefore,XELOX provides a more cost-effective adjuvant chemotherapy for colon cancer patients in China. AIM: To compare XELOX and FOLFOX4 as colon cancer adjuvant chemotherapy based on MOSAIC and No.16968 trails from Chinese cost-effectiveness perspective. METHODS: A decision-analytic Markov model was developed to compare the FOLFOX4 and XELOX regimens based MOSAIC and No.16968 trial.Five states were included in our Markov model: well (state 1), minor toxicity (state 2), major toxicity (state 3), quitting adjuvant chemotherapy (state 4), and death due to adjuvant chemotherapy (state 5). Transitions among the 5 states were assumed to be Markovian. Costs were calculated from the perspective of the Chinese health-care payer. The utility data were taken from published studies. Sensitivity were used to explore the impact of uncertainty factors in this cost-effectiveness. analysis. RESULTS: Total direct costs of FOLFOX4 and XELOX per patient were $ 19884.96 ± 4280.30 and $ 18113.25 ± 3122.20, respectively. The total fees related to adverse events per patient during the entire treatment were $ 204.75 ± 16.80 for the XELOX group, and $ 873.72 ± 27.60 for the FOLFOX4 group, and the costs for travel and absenteeism per patient were $ 18495.00 for the XELOX group and $ 21,352.68 for the FOLFOX4 group. The base-case analysis showed that FOLFOX4 was estimated to produce an additional 0.06 in quality adjusted life years (QALYs) at an additional cost of $ 3950.47 when compared to the XELOX regimen over the model time horizon. the cost per QALY gained was $ 8047.30 in the XELOX group, which was $ 900.98 less than in the FOLFOX4 group ($ 8948.28). one way sensitivity analysis demonstrated that the utility for the well state and minor toxicity state greatly influenced the incremental cost-effectiveness ratio of FOLFOX4. CONCLUSION: In term of cost-comparison, XELOX is expected to dominate FOLFOX4 regimes; Thus, XELOX provides a more cost -effective adjuvant chemotherapy for colon cancer patients in China.