OBJECTIVES To estimate the expected health benefits, costs and incremental cost-effectiveness ratio of routine vaccination with the new 10-valent pneumococcal non-typeable haemophilus influenzae protein-D conjugate vaccine (PHiD-CV) compared with no vaccination and the currently available 7-valent pneumococcal conjugate vaccine (PCV-7) in Sweden. METHODS A cross-sectional population model was used to estimate the impact of vaccination over 1-year at vaccine steady-state and to perform an incremental cost-effectiveness analysis, comparing 3 different vaccination strategies. The base-case analysis was performed from a societal perspective, using a 3 dose (2+1) vaccination schedule. The effects of herd-protection, serotype replacement and serotype cross-protection were calculated separately. The main outcomes were measured by reduction in the disease burden, costs, QALYs and incremental cost-effectiveness ratio (ICER) per QALY gained. Sensitivity analyses were performed to evaluate the robustness of the model. RESULTS Preliminary results indicate that PHiD-CV could prevent a considerable number of pneumococcal infections- particularly acute otitis media. Annual healthcare costs (vaccine costs excluded) and indirect costs with PHiD-CV are estimated at 10% and 12% lower than with the no vaccination strategy, and 6% and 7 % lower, than with PCV-7. Expected QALY gain from vaccination is twofold compared with PCV-7. At price-parity, health benefits of vaccination can be achieved with a “low cost” per QALY (CONCLUSIONS Our preliminary results indicate that the health benefits of vaccination with PHiD-CV compared with no vaccination and PCV-7 can be achieved within a “low cost” per QALY gained, according to the Swedish National Board of Health and Welfare's ranking.