This study estimated the impact of routine vaccination of infants with a new 10-valent pneumococcal nontypeable Haemophilus influenzae protein D conjugate vaccine (PHiD-CV) on health outcomes and costs across the entire population in Canada, Germany, Mexico, and Norway. A compartmental, static model with a 1-year time period for a steady-state population that allowed for the incorporation of direct and indirect (i.e., herd immunity and serotype replacement) vaccine effects across all age groups was used. Cases of disease prevented, deaths prevented, life-years gained, quality-adjusted life-years gained, and incremental costs in the steady-state year were calculated for PHiD-CV compared with 7-valent pneumococcal conjugate vaccine (PCV-7). A short-term analysis was also conducted to estimate the incremental difference in disease and cost outcomes for the two vaccines within the first 10 years. All costs were in 2008 local currency. In all four countries, the model estimated that PHiD-CV prevented more cases of disease, prevented more deaths, and resulted in more life-years and quality-adjusted life-years compared with PCV-7 in both the short term and the steady-state year. Assuming price parity for the vaccines, the model projected that routine vaccination with PHiD-CV resulted in lower costs compared with PCV-7 in both the short term and the steady-state year. Scenario analysis showed the incremental cost savings for PHiD-CV compared with PCV-7 in the steady-state year were sensitive to assumptions regarding duration of vaccine efficacy.