Can Better Tax Rules Help Promote Gluten-free Diet for Celiacs?

Celiac.com 02/23/2016 - An estimated 350,000 Canadians have been diagnosed with celiac disease. For these people following a strict gluten-free diet is essential, not only for gut healing and symptom relief, but to avoid celiac-related complications such as anemia, osteoporotic fractures and small bowel lymphoma.

However, a gluten-free diet can be challenging to follow, inconvenient and expensive. To help reduce costs and make things easier for celiacs, authorities have tried various schemes, including tax reduction, cash transfer, food provision, prescription and subsidies.

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But what works best? A team of researchers recently assessed the tax-deductible provisions for a gluten-free diet in Canada compared it with other countries.

The research team included MI Pinto-Sanchez, EF Verdu, MC Gordillo, JC Bai, S Birch, P Moayyedi, and P Bercik. Their recent review highlights advantages and disadvantages in relation to promoting compliance with a gluten-free diet.

The tax offset system used in Canada for gluten-free diet coverage takes the form of a reimbursement for prior food costs. Hence, the program does not help celiac patients reduce the costs of gluten-free foods, it just provides a later refund of a portion of those costs.

In the research team's view, the best approach would lie in subsidizing gluten-free products through controlled vouchers or direct food provision to those who most need it, independent of 'ability or willingness to pay'. Moreover, they suggest, if such a program is too costly, the value of the benefits could be made taxable to ensure that any patient contribution, in terms of additional taxation, is directly tied to the ability to pay.

The team says the limited coverage of Canadians' gluten-free diets is concerning, and suggest that there is a substantial unmet need for gluten-free dietary resources among celiac patients in Canada.

Ultimately the team recommends that the Canadian medical community and the Canadian Celiac Association take a larger role in promoting improved access to gluten-free resources for people with celiac disease.

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