The Scottish Medicines Consortium (SMC) has accepted esomeprazole (Nexium®) for restricted use within NHS Scotland, for patients in the age group 12-17 years inclusive, for the treatment of erosive reflux oesophagitis, the long-term management of patients with healed oesophagitis to prevent relapse, and the symptomatic treatment of gastro-oesophageal reflux disease. The use of esomeprazole for this indication and age group should be restricted to patients in whom maximum licensed doses of generic proton pump inhibitors have been ineffective.

Based upon 25% of adolescent GORD patients failing on other proton pump inhibitors, the manufacturer estimates that around 370 would be eligible for esomeprazole in year 1 in Scotland, rising to 480 by year 5. If all used esomeprazole this would have a direct gross drug cost of £27,831 in year 1 rising to £36,280 by year 5. The parallel figures for other proton pump inhibitors are approximately £4000 lower.