With the cost of gluten-free bread up to four times greater than normal bread, having coeliac disease is expensive. But given that a lifelong strict adherence to a gluten-free diet is the only treatment, who should bear the brunt of this cost?
Public health bodies may also have a role to play – in the UK gluten-free staples such as bread are currently available on prescription to coeliac sufferers who apply to the Advisory Committee on Borderline Substances (ACBS), a public body which approves non medicines or medical devices as prescription items.
But Sarah Sleet, CEO of Coeliac UK, warned that with NHS budget cuts this service had already begun to be squeezed, further leaving coeliacs out of pocket.
For Susanne Döring, secretary general of the International Association of Plant Bakers (AIBI), the fact that gluten-free products are more expensive is inevitable because they cost more to produce – it is not because manufacturers are seeking higher profit margins.
“As gluten-free products are not mainstream products, the production costs (own and separate production lines are necessary) and raw material costs are higher,” she said.
“The higher regulatory costs (‘no gluten’ labelling etc.) are also a reason for a more costly end product.”
She added that opting for low-cost gluten-free alternatives such as potatoes and oats could be a money-saving option - although even oats are not suitable for all coeliacs.
Euromonitor analyst Simone Baroke claimed the food industry was losing out by not proactively encouraging consumers to seek a medical diagnosis if they suspect a gluten-intolerance.
For Sleet, industry does have a role to play but cannot be held solely accountable.
“Responsibility for diagnosis of the condition cannot be attributed to one group of stakeholders alone. Public awareness of the importance of having a diagnosis of coeliac disease and the benefits of its treatment – the gluten-free diet – sits with a number of interested parties, with manufacturers and retailers both having a role to play in providing customer information,” she said.
According to Döring, however, responsibility for diagnosis sits firmly with medical practitioners.
“Industry should not encourage consumers to have an invasive and unpleasant diagnostic test for gluten free. This lies in the responsibility of medical doctors and generalists to decide about the correct treatment and prescribe the test for patients.”
Döring said the industry’s role was to provide practical solutions – and this meant making sure that a range of alternative products was available in both supermarkets and specialised shops.
Sleet said that another major barrier for many coeliacs was availability, as many retailers do not stock a free-from range. But some manufacturers are doing their best to boost their retail shelf space.
One, The Black Farmer, has turned the availability issue to its advantage in terms of increasing distribution, encouraging consumers who visit its website to use Twitter to petition retailers to stock its products. The site claims “If we make enough noise, the supermarkets will listen to you and what you want!” and provides links to the sites of all major UK retailers.
Meanwhile, consumers can order their gluten-free Warburton products from their local pharmacy through its website.
The Coeliac UK website has a page specially dedicated to retailers and manufacturers with tips and information on launching gluten-free products.
"We can help by providing you with up to date information on the gluten-free market, and referring you to appropriate agencies for advice on legislation and labelling, quality control and gluten testing."