A recent study (AR Lee et al. Nutrients; 2019, 11, 399). Open access: Persistent Economic Burden of the Gluten Free Diet) quantifies the additional costs of a gluten free diet (GFD) in the U.S. Thanks to Kipp Ellsworth for this reference.

The authors conducted a “market basket” study to establish the cost of a GFD. “A market basket is a group of products that are purchased by consumers …for this study, the market basket was food that would necessitate a GF substitute, including staple foods, snack foods, and commonly used ready-made or convenience meals.”

Key findings:

• GF products were more expensive, overall the increase was 183%.  This is an improvement from a 2006 study which found the increase overall at 240% (adjusted for inflation).
• Mass-market products were 139%  more expensive than wheat-based versions

Discussion:

• Cost is identified as a frequent reason for nonadherence with diet, cited by 33% in one study
• Overall, the burden of GFD is more frequently related to the restrictive nature of the diet which leads to a negative impact on quality of life. According to the authors, in one study (Am J Gastroenterol 2014; 109: 1304-11), treatment burden for celiac was ranked higher than for diabetes hypertension, and congestive heart failure

My take: This study shows the significant economic burden of a GFD.  In Italy, the  “government offers celiac patients vouchers to buy gluten-free food — up to 140 euros per month.” (NPR: Italy, Land of Pizza and Pasta)

Related blog posts:

• Lost Boys (& Girls) of Celiac This blog documents frequent occurrence of patients being lost to followup.  It is likely that cost is a factor in this situation as well.
• Is it Helpful to Check Celiac Serology Three Months After Gluten Free Diet?
• How Accurate is Serology at Predicting Mucosal Healing in Pediatric Celiac Disease?
• Closer followup for Celiac disease & pediatric guidelines
• Celiac serology normalization
• How Slow Do Objective Markers of Celiac Change After Treatment? | gutsandgrowth
• Celiac Disease Epidemic (High rate of celiac disease reported in Denver children)
• Vaccine for Celiac Disease
• Celiac Disease Risk –TEDDY study