The media report yesterday on Newsnight on the cost to the NHS of gluten-free prescriptions conflates two important issues.
We are glad that the contributors acknowledge the important role prescriptions of staple products such as breads, flours and pastas can play in helping patients stick to a strict gluten-free diet. This is the only treatment for coeliac disease, a serious autoimmune disease, 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.
As stated on Newsnight, Coeliac UK does not support the prescribing of luxury products such as cake mixes and chocolate biscuits on prescription. We have issued national guidance which states that prescriptions should focus on staple products such as breads, flours and pastas.
Our understanding is that the prescribing of such products is very rare and due to individual prescribing decisions by doctors. Whilst we do not believe the cost to the NHS is significant in practice, we still recommend that the national guidance focusing on staple products is adhered to.
It is also important to highlight that in England, prescriptions for gluten-free food are not free of charge unless a person qualifies for free prescriptions.
We believe the more significant issue is the additional costs quoted in the report and these 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 to gluten-free items. 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 in treating the serious long term complications of not keeping a strict gluten-free diet.
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 seven areas of the UK and we would like to see it rolled out nationwide.
http://www.coeliac.org.uk/Gluten-freesupplytoolkit