OBJECTIVE: To estimate the cost-effectiveness and program costs of vaccination with hexavalent meningococcal B outer-membrane-vesicle (OMV) vaccine within the framework of the Dutch vaccination programme for new-borns. METHODS: A pharmaco-economic decision-analysis model was applied, linking epidemiological and economic data. Epidemiological data were obtained from the Netherlands Reference Laboratory for Bacterial Meningitis. Standard methods for cost-effectiveness analysis were used. Analysis was done from a societal perspective, including direct and indirect costs of productivity loss (friction-costs method; price levels in 1998 €; discount rate of 4%). Cost-effectiveness ratios were expressed in net costs per quality adjusted life year (QALY) gained. Sensitivity analysis was performed on several key parameters of the model. RESULTS: In the base-case, through vaccination 480 QALYs are gained, while total net costs of the programme are € 5,546,923. The cost-effectiveness ratio is € 11,600 per QALY gained. Sensitivity analysis indicates a cost-effectiveness range of € 5,841 to 30,543 per QALY gained. CONCLUSIONS: Vaccination of all new-borns with meningococcal OMV vaccine has an acceptable cost-effectiveness ratio compared to other interventions in the Netherlands.