OBJECTIVES: Recently, 13-valent Pneumococcal Conjugate Vaccine (PCV13) has been approved for adults 50 years of age and older for the prevention of invasive pneumococcal disease (IPD) caused by the vaccine serotypes. This study was aimed to assess the clinical and economic impact of PCV13 use in adults with immunocompromising conditions based on HIV published data. METHODS: A budget impact model for the whole HIV population was designed under the Spanish National Health System with a 4-year time horizon. Calculations of cases were based on the published IPD incidence (0.74%) and recurrent IPD ratio in this population. From total IPD cases, 92% were considered bacteraemia originating from pneumonia, 5.5% bacteraemia without apparent focus and endocarditis and 2.5% meningitis. PCV13 efficacy, serotype coverage, IPD mortality and disease related costs were based on published data. Model was built up assuming full vaccination coverage and no indirect effect. All costs were expressed in €2012. RESULTS: There would be 2,392 IPD cases in Spanish HIV patients over 4-year time horizon (598 annual cases). The model predicts that the implementation of a PCV13 vaccination program for HIV population would be a cost saving measure due to IPD cases averted. Over the study period, PCV13 would prevent 646 IPD cases and 162 related deaths. CONCLUSIONS: Based on this health economic evaluation, the inclusion of a PCV13 vaccination program for HIV population would be an efficient measure.  PCV13 vaccination would have a high impact on pneumococcal disease prevention, avoiding deaths and saving costs.