OBJECTIVES: Streptococcus pneumonia causes a number of clinical conditions, including pneumonia, meningitis, bacteremia, sepsis, and acute otitis media (AOM). The objective of this study is to estimate the potential effectiveness and cost-effectiveness of vaccinating infants with the pneumococcal non-typeable Haemophilus influenzae Protein D conjugate vaccine (PHiD-CV) compared to the 13-valent pneumococcal conjugate vaccine (PCV-13) in Croatia. These vaccines are currently available only for risk groups and on private market with a limited uptake, representing less than 10% of annual birth cohort.  METHODS: A Markov cohort model with a starting birth cohort of 39,939 infants and a 100-year time horizon was used to project the impact of vaccination on the incidence of pneumococcal diseases. In the model, individuals move between mutually-exclusive health states and direct treatment costs and quality-adjusted life years (QALYs) are aggregated and discounted (3%) in monthly cycles. Vaccine regimen was