24 May 2012

The media reports today of the cost to the NHS of gluten-free prescriptions highlights some important issues.

We are glad to see the Secretary of Health, Andrew Lansley’s comment that: “The aim of providing gluten-free food products on prescription is to encourage patients with coeliac disease to stick to a gluten-free nutritious diet so that they do not go on to develop more serious illnesses…”

The only treatment for coeliac disease, a serious autoimmune disease, is a lifelong strict gluten-free diet without which patients are at risk of osteoporosis, infertility and some gut cancers. But keeping to such a diet is very difficult as many independent research studies have shown.

Accessing gluten-free breads, flours and pastas in the supermarkets is not as easy as people think. Such products have been shown to be ‘virtually absent’ from budget and convenience stores and where they are available, they will cost three to four times more than their gluten-containing equivalents. This will add many hundreds of pounds to the annual shopping bill making them unaffordable for vulnerable patients.

The additional costs quoted in the media are of great concern to us. Agreement on the reasonable cost of products is made at a national level. We are aware that NHS commissioners have come across evidence of additional local charges being added to products and as a result are restricting access. The patient is losing out as a result.

We need the situation resolved as quickly as possible to ensure this important service remains available, keeping people with coeliac disease healthy and avoiding adding more cost to the NHS long term in treating the serious long term complications of not keeping a strict gluten-free diet.

Media reports also quote the availability of cake mixes and chocolate biscuits on prescription. We do not support such prescribing. We have issued national guidance which states that prescriptions should focus on staple products such as breads, flours and pastas.

We have worked over the last few years with pharmacists’ organisations to develop a scheme to supply gluten-free prescriptions which cuts the cost to the NHS. The scheme allows patients to deal direct with pharmacists, improving their satisfaction with the service and reducing their time at the GP surgery. The scheme is already working well in nine areas of the UK and we would like to see it rolled out national wide. You can read more about this scheme here and find an example of it in practice on the BBC website.