OBJECTIVES: To compare the costs and consequences of Enteryx with Laparascopic Nissen Fundoplication (LNF) and pharmacological therapy (PPIs) in patients with Gastro-Oesophageal Reflux Disease (GORD). The Enteryx Procedure is a new endoscopically injected polymer-based treatment for GORD. METHODS: A decision analytical approach was taken to model the ability of the three interventions to successfully treat patients with GORD. The model time horizon was one year with an additional 5-year long-term perspective. The clinical outcomes and the resource consumption data for PPIs were derived from the literature. A multicentre clinical study of Enteryx provided the clinical outcomes for Enteryx. Treatment outcomes following LNF were sourced from the literature. Experienced UK experts provided resource consumption data for the Enteryx procedure and LNF. Patients on pharmacological treatment (PPIs) with relapse followed the recommended route of moving to higher dose therapy for eight weeks and if still not responding received a further 8 weeks followed by an endoscopy. RESULTS: At 1-year average costs per patient were lower with Enteryx (£2683) than with LNF (£4718). The cost of PPI treatment at 1 year amounted to £394 for all patients and to £691 for patients needing a higher dose of treatment. At 5 years, Enteryx patients had a lower cost of £3004 per patient compared to LNF (£4769) and high dose PPI users (£3457). The average cost for all PPI users at 5 years was £1970. CONCLUSIONS: For those patients suitable for surgery, Enteryx provides a less expensive option than LNF largely due to the reduced hospitalisation and procedure costs. Due to the recurrent nature of PPI treatment and cost, Enteryx is a cost saving therapy in the long-term compared to pharmacological therapy, especially for patients on high maintenance dose.