Between eating cake, I have occasional moments of coeliactivism. Some time ago I wrote this article, speculating on some of the issues surrounding gluten free prescribing. As I work on the border of the healthcare system I guessed that the NHS may not be getting value from gluten free product manufacturers. Discussion on twitter inspired me to look into this a little more deeply- specifically by creating a Freedom of Information request to understand the cost of gluten free foods to the NHS so that I could make a comparison with high street equivalents.
This required a little more investigation than planned, as my PCT directed me to the BNF who hold the information. Anyone can request access to the BNF and access data on how much the NHS pay for a prescribed product (excluding any discount or rebate agreements they might have with the manufacturer) however the BNF heavily restrict use and reproduction of their data.
I had intended to complete a properly referenced, thorough analysis of the data I received to draw conclusions about average % difference in price between prescribed and consumer products. Combined with another information request about volumes of prescriptions, this would be evidence for or against wastage in the NHS system. Unfortunately the full time job and the restrictions on using the BNF data get in the way, so instead I have used the BNF as a guide to pinpoint some interesting items of data and turned to my friendly local pharmacist who was able to tell me specific details to illustrate my points here.
Whilst this doesn’t show you conclusively that NHS money is being wasted, it is pretty suggestive that the NHS is not getting the best deal from some of the gluten free brands.
For products that span consumer and prescription markets, the NHS pays a comparable price to the high street
I was relieved to find in the majority of cases, the NHS pays a comparable price per unit for food as you would on the high street. For example, a loaf of white Genius bread costs the NHS £2.59, or £2.60 to you from Tesco. A similar story for other brands where the product spans both the prescription and consumer market like Glutafin and Warburtons.
But on further consideration, it surprises me that considering the volume of purchases that the NHS must be making of these products, and that the price we pay in the supermarket also includes a mark-up from the retailer, that the NHS doesn’t pay less per unit that we do with our own pennies. It seems there is definitely some room for negotiation there.
In some cases, the NHS seems to pay over the odds for gluten free foods
The shocking finding was that in lots of cases, particularly where brands don’t compete with their products on the open market, prices are exorbitant. For example Juvela spaghetti costs the NHS £6.51 for 500g compared to the £1.99 Waitrose equivalent. Shop-bought Doves’ Farm Flour mix is less than 1/4 the price of NHS Barkat flour mix.
There are many examples spanning all of the food categories including breads, pastas, crackers and biscuits. To me this suggests manufacturers profiteering in a dreadful way from the NHS.
What can we do?
Let’s be honest. Changing massive, heavy institutions and challenging profit-making businesses is hard – and that’s probably why the easier route for the NHS is to cut prescription provision rather than address these problems. But that doesn’t mean we shouldn’t try. Some suggestions we coeliactivists can personally take up to help our beloved healthcare system:
- Be a good citizen and sign up to the BNF to see how much your prescription is costing the NHS. You might find that there are some cheaper alternatives that your GP could switch you to.
- Contact the gluten free manufacturers to ask why they are charging the NHS so much for their products compared to their supermarket counterparts.
If anyone does receive a reply from a manufacturer, or has time to look into this more in depth or do a more complete analysis, I would be very interested to see their findings! Or if you have any thoughts or ideas on what else use coeliacs can do to make sure there are no more cutbacks.