Gluten-free foods are expensive. So expensive that some countries, such as France, Italy, Canada, and parts of the UK, offer some relief to people with Celiac disease (CD) with different support (such as tax breaks or food subsidies, etc.) In some parts of the UK, people with CD have been able to secure gluten free (GF) food through pharmacies, via prescriptions. These supports have since been questioned, and some jurisdictions have withdrawn support for GF food on prescription. What impact has this had? This research aims to find out, and the results may not surprise you. Check out the abstract below, and then click through to the main article to learn more.
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The affordability and obtainability of gluten-free foods for adults with coeliac disease following their withdrawal on prescription in England: A qualitative study
Peer-reviewed research by: Helen Crocker, Thomas Lewis, Mara Violato, and Michele Peters
Abstract
Background
Changes to prescribing policies in England have restricted or stopped access to gluten-free food on prescription for people with coeliac disease in some geographical areas. The present study aimed to explore the impact of these changes on the affordability and obtainability of gluten-free foods for adults with coeliac disease.
Methods
Semi-structured qualitative interviews (n = 24) were conducted with people with coeliac disease living in areas where prescriptions for gluten-free foods were no longer available, were restricted or followed national guidelines. Interviews explored the impact of gluten-free prescribing changes on the affordability and obtainability of gluten-free food, as well as dietary adherence.
Results
All participants considered gluten-free substitute foods to be expensive. Participants felt the availability of gluten-free foods has improved over time, also acknowledging some challenges remain, such as limited local availability. For most, the withdrawal of prescriptions had minimal impact requiring small adjustments such as reducing the quantity of foods obtained. However, greater challenges were faced by those less mobile, permanently sick or disabled and/or on lower incomes.
Conclusions
The majority of participants affected by the withdrawal of prescriptions were able to adapt to cope with these changes. However, participants with mobility issues, who are permanently sick or disabled and/or on lower incomes were struggling to afford and obtain gluten-free substitute foods from elsewhere. The withdrawal of prescriptions may further widen health inequalities. Further research should focus on the long-term impacts of prescription withdrawal for the vulnerable groups identified.
Key points
- Prescriptions for gluten-free substitute foods have been restricted or withdrawn in some areas of England, but the impact of these changes on people with coeliac disease is unknown.
- The present study found that the majority of people with coeliac disease were able to adapt to cope with prescribing changes, but certain groups (people with mobility issues, who are permanently sick or disabled and/or on lower incomes) were struggling to afford and obtain gluten-free foods.
- Future research should focus on the longer-term impacts of no access or restricted access to gluten-free substitute foods on prescription, with specific focus on the groups identified above.
Click here to read the full open-access article, published in 2023 in the journal Journal of Human Nutrition and Dietetics.
Full Reference //
Crocker H, Lewis T, Violato M, Peters M. The affordability and obtainability of gluten-free foods for adults with coeliac disease following their withdrawal on prescription in England: a qualitative study. Journal of Human Nutrition and Dietetics, 37:47–56.
This article is licensed under a Creative Commons Attribution 4.0 International (CC BY 4.0).
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