OBJECTIVES:   To estimate the disease burden and economic impact of the 10-valent pneumococcal non-typeable Haemophilus influenzae (NTHi) protein D conjugate vaccine (PHiD-CV) compared with 13-valent pneumococcal conjugate vaccine (PCV13) in Finland based on recently generated vaccine efficacy/effectiveness data. To date, vaccine efficacy of the second generation pneumococcal conjugate vaccines (PCVs) on invasive pneumococcal disease (IPD) and pneumonia has been extrapolated based on 7-valent PCV (PCV7) efficacy data and serotype distribution. Impact of PCVs on IPD and pneumonia is now observed in post-marketing settings in several countries and the effectiveness of PHiD-CV against IPD has recently been demonstrated in a clinical trial in Finland. METHODS: A Markov cohort model was used to estimate the clinical and cost burden of pneumococcal and NTHi-related diseases in a birth cohort over lifetime and to measure the clinical and economic impact of PHiD-CV compared with PCV13 in Finland. Age-specific incidences of IPD, pneumonia and acute otitis media (AOM) and direct medical costs were calculated and used as input data. Only the direct effect of vaccination was assessed. Outcomes were measured by reduction in disease burden, costs, quality-adjusted life-years (QALYs) and incremental cost-effectiveness ratio. RESULTS: The model predicts that PHiD-CV and PCV13 may have a similar impact on IPD and pneumonia in a pediatric population. PHiD-CV is estimated to prevent an additional 26,576 AOM cases and 2,502 myringotomy procedures versus PCV13 in a country with a birth cohort of 57,000 infants. This translates in an additional reduction of medical costs by EUR 8,470,547 (discounted with 3%). Cost-effectiveness analysis showed that PHiD-CV provides 135 more QALYs (discounted) while saving cost compared with PCV13. Universal infant vaccination with PHiD-CV provides more HE benefits than PCV13. CONCLUSIONS: Nation-wide infant vaccination with PHiD-CV in Finland is projected to improve health outcomes and be a cost-saving strategy. Funding: GlaxoSmithKline Biologicals SA