Carroll T, et al. – The experts wished to evaluate an alternate empiric dosing regimen and consider up–front, pH–impedance, and manometry testing in order to minimize cost for treating subjects with laryngopharyngeal reflux (LPR) disease. Outcomes showed that the majority who presented with presumed LPR were improved with an alternate QD/QHS (quaque die/ quaque hora somni) regimen. However, the QD/QHS regimen was more expensive than the initial BID (bis in die) high–dose proton pump inhibitor (PPI) for 6 months. Overall per–patient cost appeared less with up–front multichannel intraluminal impedance (MII) and high–resolution manometry (HRM).