Cutting gluten free prescriptions won’t save the NHS money — It’ll cost more in the long run

19 March 2025, 08:18

By Tristan Humphreys

With a weekly gluten free food shop costing up to 35% more than a regular shop, the unfortunate reality for many with coeliac disease is the gluten free food they need to treat their condition is too expensive and hard to access.

For this reason, gluten free bread and flour have historically been made available to people with coeliac disease on prescription, just like any other treatment. However, in recent years this lifeline has come under threat, and for many, been withdrawn completely.

Coeliac disease is a serious autoimmune disease affecting around 1 in 100 people, for which the only treatment is a strict gluten free diet for life. If left untreated, it can lead to serious health complications such as osteoporosis, neurological dysfunction, unexplained infertility or even in rare cases, small bowel cancer. These withdrawals are therefore devastating for those living with the condition.

Commissioning decisions are made by local Integrated Care Boards (ICBs) in England and in recent years, many of these commissioners have chosen to cut gluten free prescriptions to save money but this is short-sighted, counter-productive and often draws on flawed evidence that overlooks its impact on health inequalities. This is devastating for the people with coeliac disease cut adrift with debilitating symptoms and at risk of serious health complications but also bad news for the NHS that has to pick up the costs of far more expensive treatments down the line.

Gluten free prescriptions spend is equivalent to just 0.07% of overall prescribing spend in England, but the cost of treating the long-term impact of not adhering to a gluten free diet, such as osteoporosis, is far greater. The average cost to the NHS of an osteoporotic hip fracture is £27,000 –the equivalent to more than a lifetime’s supply of gluten free prescribing for one person.

Withdrawing prescriptions risks many people with coeliac disease being left unable to afford the staple gluten free substitutes they need to treat their autoimmune condition. This will affect vulnerable communities the most; those least able to absorb the additional financial cost of accessing gluten free staple substitute products and overcome the limited access in more deprived or rural communities. Indeed, this reality has been recognised by some ICBs in recent years. 

In 2023, South Yorkshire, South West London and Kent and Medway ICBs took the decision to align their policies with Coeliac UK guidance for England, and in doing so, reinstate gluten free prescriptions in Sheffield, West Kent, Croydon, Kingston, Merton and Richmond. South Yorkshire ICB cited health equality concerns as a key driver for this decision.

More than 20,000 people have signed our petition in support of protecting gluten free prescriptions. This petition hand in marks an important step in making a real difference to the affordability of gluten free food.

We welcome the Government's 10 Year Health Plan and in particular its commitment to moving from sickness to prevention.  So, we’re calling on the UK Government to take action. Work with people with coeliac disease and healthcare professionals to address this unfair postcode lottery.

For so many across England, gluten free prescriptions are a lifeline. Let’s not leave them adrift.

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Tristan Humphreys is Head of Advocacy & Public Affairs at Coeliac UK.

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