The economic burden of gluten-free products and gluten-free diet: a cost estimation analysis in Greece.

BACKGROUND: Adherence to a gluten-free diet (GFD) demonsrates various difficulties, including the high cost of the diet. The present study aimed to (i) compare the cost of gluten-free products (GFP) from supermarkets and pharmacies with the cost of their conventional counterparts and (ii) estimate the weekly economic burden of a GFD.

METHODS: The prices of all food products labelled as 'gluten-free' available at four supermarket chains in Athens, as well as the prices of all similar conventional food products, were recorded. The prices of the pharmacy GFP were recorded from the official list of the National Health Service Organisation. For every product, the price per 100 g was calculated. All products were classified into 24 categories, which consisted of three subcategories: conventional, supermarket GFP and pharmacy GFP. Three weekly menus were designed for children, adolescents and adults, selecting the upper levels of energy intake, to cover the majority of the patients. For all three weekly menus, the price difference between conventional and GFP, both from supermarkets and pharmacies, was calculated.

RESULTS: Compared with conventional food products, all supermarket GFP, except for one, were more expensive by 22-334% (P < 0.05) and all pharmacy GFP were more expensive by 88-476% (P < 0.05). The weekly economic burden of a GFD ranged from €12 to €28 per week, depending on age and GFP place of purchase.

CONCLUSIONS: The present study confirms the higher cost of GFP compared to their conventional equivalents in Greece, leading to a weekly economic burden for people on a gluten-free diet.