BACKGROUND: Pneumococcal diseases (PD), such as bacteremia, meningitis and pneumonia, are associated with substantial burden in adults (>50 years). Moreover, adults with underlying chronic conditions (i.e., vascular, metabolic, or respiratory diseases) have shown to have 3–6 times higher risk of PD compared with their healthy controls. These people at higher risk will likely benefit most of PCV13 vaccination in the new adult indication. OBJECTIVES: To estimate the expected 5-year economic impact of targeted PCV13 vaccination compared to no vaccination in Finnish adults (>50 years) at higher risk for PD. METHODS: A budget impact model applying a modified Markov-type structure was developed to predict the impact of PCV13 vaccination in terms of costs and PD events avoided. The model was built as a dynamic open-cohort model to allow the annual evolution of the size of prevalent target population with considered PCV13 indications. The results of model were extrapolated for the years 2012-2016 by applying population forecasts from the official Finnish statistics. Health care resource use and Finnish unit costs (€2011, societal perspective) were obtained from published national sources. RESULTS: Approximately 35% of the 2.2 million Finns of over 50 years of age can be considered to be at moderate or high risk for PDs due to the underlying chronic medical conditions. The vaccination of these people with PCV13 could provide an estimated net budget savings of about €218 million compared to the current no-vaccination situation during the five years. Among the risk groups considered, the largest net savings (€66.2 million) could be expected to be obtained by vaccinating people with heart disease due to its high prevalence in the target population. CONCLUSIONS: The immunization of adults (>50 years) at higher PD-risk with PCV13 vaccine will potentially lead to substantial cost savings during the forthcoming years in Finland.