{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T00:30:28Z","timestamp":1747182628643,"version":"3.40.5"},"reference-count":37,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2023,9,4]],"date-time":"2023-09-04T00:00:00Z","timestamp":1693785600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J of Rheum Dis"],"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Systemic sclerosis (SSc) patients often become refractory to proton pump inhibitors (PPI)\u2014a standard treatment for gastroesophageal reflux disease (GERD)\u2014and intolerant to PPI in combination with domperidone. PPI with alginic acid is an alternative treatment option, but alginic acid is costly.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>We compared the costs and effectiveness of alginic acid plus PPI versus standard treatments (PPI with\/without antacids as needed and lifestyle modifications) for GERD in SSc patients unsuitable for, or intolerant to, domperidone.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>An economic evaluation using the Markov model was conducted among SSc patients aged between 40 and 65\u2009years with GERD, having a partial or non\u2010response to 4\u2009weeks of standard\u2010dose omeprazole (40\u2009mg\/day) and being unsuitable for or intolerant to domperidone. Using a societal perspective, we computed the incremental cost\u2010effectiveness ratios (ICERs) in terms of Thai baht (THB) per quality\u2010adjusted life\u2010year (QALY) between a combination of alginic acid plus PPI and standard treatment for GERD. The lifetime time horizon was used.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The ICER for alginic acid plus PPI versus standard treatments was 377\u2009101\u2009THB\/QALY. According to the one\u2010way sensitivity analysis, the cost of alginic acid was the most impactful parameter. If the market prices of alginic acid plus PPI were reduced by 61%, this treatment option would become cost\u2010effective at the willingness\u2010to\u2010pay threshold of 160\u2009000\u2009THB\/QALY (34.68\u2009THB\/USD data on 25 May 2023). Furthermore, if alginic acid were included in the public health insurance program, the national budget would be increased by 66\u2009313\u2009THB per patient, resulting in an overall budget increase of 5\u2009106\u2009101 to 8\u2009885\u2009942\u2009THB compared with the standard treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Alginic acid plus PPI does not represent good value for money compared with the standard treatment among such SSc patients in Thailand unless its price is reduced significantly.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1756-185x.14868","type":"journal-article","created":{"date-parts":[[2023,9,4]],"date-time":"2023-09-04T11:04:46Z","timestamp":1693825486000},"page":"2037-2046","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Cost\u2010effectiveness of alginic acid in combination with proton pump inhibitor for the treatment of gastroesophageal reflux disease in systemic sclerosis patients"],"prefix":"10.1111","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1964-4389","authenticated-orcid":false,"given":"Chingching","family":"Foocharoen","sequence":"first","affiliation":[{"name":"Department of Medicine, Faculty of Medicine Khon Kaen University  Khon Kaen Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pritaporn","family":"Kingkaew","sequence":"additional","affiliation":[{"name":"The Health Intervention and Technology Assessment Program (HITAP), Department of Health Ministry of Public Health  Nonthaburi Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yot","family":"Teerawattananon","sequence":"additional","affiliation":[{"name":"The Health Intervention and Technology Assessment Program (HITAP), Department of Health Ministry of Public Health  Nonthaburi 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