OBJECTIVES: Streptococcus pneumoniae causes significant morbidity and mortality worldwide in both children and adults. The aim of this analysis is to evaluate the cost-effectiveness of vaccinating colombian population over 50 years with 13-valent pneumococcal conjugated vaccine (PCV 13) from the institutional perspective in Colombia. METHODS: A Markov model was adapted to Colombian settings, using a time horizon of 5 years (3% annual discount rate). Comparators were PCV13, PPSV23 and no vaccination, vaccine coverage was 70%. Population size over 50 years of a Colombian insurance institution (n: 775,301) adjusted according with Colombian data was included, transition probabilities were extracted from a literature review, medical costs were taken from a local study developed by the “Fundación Cardio Infantil”, vaccines costs were taken from local report (SISMED), the diseases incidence was retrieved from literature (Castañeda et al. 2010, Dickinson et al 2001), vaccines efficacies were taken from literature (for PCV13 children data from PCV7 studies were adjusted by immunosenescence) and costs are expressed in 2012 US$. Effectiveness measures were the number of pneumococcal diseases and deaths prevented, as well as life years (LY) gained saved. Probabilistic sensitivity analyses were performed. RESULTS: Over a 5-year period, vaccinating with PCV13 prevents 1,427 cases of invasive pneumococcal disease compared to PPSV23 and 1847 compared no vaccination; 1691 and 1470 cases of invasive pneumonia and 188 and 256 deaths, respectively. PCV13 saves 101,564 LY’s compared to PPSV23 and 92,261 LY’s compared to no vaccination. Total expected costs (vaccination + medical costs) were US$164.0M for PCV13, US$ 164.4 PPSV23 and US$155.0M for no vaccination. CONCLUSIONS: Vaccinating adults over 50 years with PCV13 in a Colombian insurance institution is a cost-saving alternative in comparison to PPSV23 and a cost-effectiveness alternative to no vaccination (ICER = US$ 96.6 /LY).