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Celiac.com 12/20/2024 - Living with celiac disease means more than just avoiding gluten; it involves a lifelong commitment to a strict diet that ensures every ingredient and meal is free from even trace amounts of gluten. However, the financial burden of maintaining a gluten-free lifestyle is significant. To help mitigate this, a new federal petition is circulating, advocating for a $1,000 refundable tax credit for Canadians with celiac disease. This proposed measure addresses the rising costs of gluten-free products and recognizes the medical necessity of a gluten-free diet for those affected. The Financial Reality of Living Gluten-Free The cost of gluten-free food can be 150-500% higher than similar gluten-containing products, creating a hefty financial burden for those with celiac disease. Betsy Hiebert, a Winnipeg-based bakery owner with celiac disease, describes how her family’s gluten-free bread costs about $11 per loaf, compared to the $6.99 spent on her husband’s gluten-containing bread. For her business, gluten-free oats are twice as expensive as regular oats due to the extensive steps needed to prevent cross-contamination with gluten. These costs reflect the need for specialized production facilities and stringent testing protocols that ensure gluten-free products are safe for individuals with celiac disease. The Hidden Costs of Cross-Contamination Prevention Hiebert highlights the scarcity of gluten-free ingredients on the Canadian Prairies, despite the abundance of crops like oats. In traditional facilities, oats often come into contact with wheat, barley, or rye, making them unsafe for people with celiac disease. To provide gluten-free options, food producers must rely on gluten-free-dedicated facilities, which adds to the price. The limited availability of such facilities in Canada further inflates the cost of gluten-free foods. This extra expense is necessary, as even trace amounts of gluten can lead to severe symptoms for those with celiac disease. Christa Dubesky, president of the Canadian Celiac Association (CCA) Manitoba Chapter, points out that gluten consumption can trigger over 300 different symptoms in individuals with celiac disease, from digestive discomfort to more systemic effects like brain fog and joint pain. Ensuring food safety is not only a dietary choice but a necessity for maintaining health and avoiding serious complications. Seeking Tax Relief: The Federal Petition for a Celiac Tax Credit While the Canadian government currently offers a Medical Exemption Tax Credit for people with celiac disease, it’s complex and not easily accessible. Melanie Bauer, a CCA Manitoba Chapter member, describes the burdensome process of tracking gluten-free grocery receipts and calculating the price difference with regular gluten products. The tax credit only applies if the additional costs exceed three percent of the household income, making it difficult for many to qualify for the deduction. For individuals like Bauer, the benefits are often not worth the time-consuming paperwork and hassle. To simplify this process and support those in need, a federal petition was launched in October 2024, calling for a straightforward $1,000 refundable tax credit. Within weeks, the petition received over 24,000 signatures, demonstrating significant public support. This tax credit would help alleviate the financial burden for Canadians with celiac disease, ensuring that they can afford the safe food they need without compromising their health. Addressing Food Insecurity Among the Celiac Community The Canadian celiac community faces additional food insecurity challenges. Bauer notes that the number of requests for gluten-free food hampers at Harvest Manitoba has more than doubled in the past three years. In addition to regular hampers, the organization now prepares a special batch of gluten-free hampers for Christmas, highlighting the increasing demand for accessible gluten-free food. Rising costs and limited options force many people with celiac disease to make difficult choices, sometimes prioritizing gluten-free food for children while risking their own health by eating gluten-containing products. Dubesky emphasizes that the proposed tax credit could reduce these struggles. For families affected by celiac disease, this financial support would enable them to maintain a gluten-free diet without straining their resources. A tax credit would make it easier for people with celiac disease to adhere to their medically necessary diets, potentially preventing adverse health outcomes and reducing their need for medical interventions. Long-Term Health and Economic Benefits of Supporting a Gluten-Free Diet Providing tax relief for people with celiac disease not only improves individual well-being but can also reduce strain on the healthcare system. When people with celiac disease are able to maintain a strict gluten-free diet, they experience fewer symptoms and avoid the long-term complications associated with gluten exposure, such as nutritional deficiencies and increased risk for certain cancers. Hiebert argues that supporting people with celiac disease in maintaining a gluten-free diet reduces their need for doctor visits, ultimately saving healthcare costs. This tax credit could make gluten-free food more accessible, enabling people with celiac disease to live healthier lives without the stress of constantly calculating their grocery bills. Additionally, it raises awareness of celiac disease as a medical condition, not a dietary choice or trend. Recognizing gluten-free food as a medical necessity supports people with celiac disease in leading active, fulfilling lives without the constant worry of hidden gluten in their meals. Conclusion: A Step Toward Inclusivity and Health Equity The petition for a $1,000 refundable tax credit is more than a call for financial support—it’s a step toward inclusivity and health equity for those with celiac disease. With the high cost of gluten-free food and the limitations of existing tax deductions, many Canadians with celiac disease are left to shoulder the financial burden of their dietary needs. This tax credit would alleviate that burden, making it easier for individuals to access the safe food they need to maintain their health and well-being. For people like Hiebert and Bauer, as well as countless others affected by celiac disease, this measure would be transformative. It would not only make gluten-free living more sustainable but would also raise awareness about the real challenges faced by those with celiac disease. The petition is an important step in recognizing the importance of accessible, safe food for all and creating a more inclusive society that understands the unique needs of those with medical dietary restrictions. Read more at: globalnews.ca
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Celiac.com 05/19/2023 - Living with celiac disease can be a challenge, and one of the biggest hurdles is the cost of gluten-free foods. Gluten-free products are notoriously expensive to begin with, and with grocery prices soaring in recent times, it's becoming increasingly difficult for those with celiac disease to keep up with the costs. Celiac disease is an autoimmune disorder that affects approximately one percent of the Canadian population. It is triggered by gluten, a protein found in wheat, rye, and barley grains, which can cause inflammation of the gut lining and various symptoms such as diarrhea, constipation, vomiting, bloating, tiredness, and headaches. For those with celiac disease, eating even a small amount of gluten can lead to long-term complications such as nutrient deficiencies, a higher risk of viral infections and pneumonia, increased risk of broken bones, and a higher risk of bowel cancer. That's why it's essential for people with celiac disease to stick to a gluten-free diet, which is medically indicated and not a personal choice. However, gluten-free products are often priced at double or triple the price of their regular gluten-containing equivalents. The recent pandemic has caused the prices of gluten-free food to rise even more. According to Celiac Canada, gluten-free products can cost between 150 and 500 per cent more than their regular gluten-containing equivalents. For many Canadians who have celiac disease, this has been a significant financial burden. A survey conducted by Celiac Canada showed that 93 per cent of respondents felt the cost of gluten-free food was more expensive than before the pandemic. Over a third of those respondents had to adjust their finances to buy the groceries they need, and one per cent had to turn to food banks. In a recent survey conducted by Celiac Canada, almost 93 percent of 7,400 Canadians, who must eat gluten-free because of their disorder, said they feel the cost of gluten-free food was more expensive than before the pandemic. Of those respondents, more than a third said they have had to adjust their finances to be able to buy the groceries they need, and one percent have had to turn to food banks. The Canadian government has announced a one-time grocery rebate for "low- and modest-income Canadians" to provide relief for Canadians as prices soar. However, Celiac Canada is calling for an increased rebate specifically for people with celiac disease in that income bracket. The association is asking for a celiac rebate of up to $230 per adult and $122.50 per child, with an extra $122.50 for people who are single. It's also worth noting that people with celiac disease can claim "the incremental costs associated with buying gluten-free food products as a medical expense" with the Canada Revenue Agency. However, doing so is an onerous task with little payout at the end, and the system is "just unworkable for the average Canadian," according to Melissa Secord, executive director of Celiac Canada. Living with celiac disease is already expensive, and the skyrocketing cost of gluten-free products only adds to the burden. In the short-term, there may be no relief in sight. However, it's important to stay informed about available resources and seek support from organizations like Celiac Canada. With ongoing advocacy and support, we can work towards making gluten-free living more accessible and affordable for all. Learn more at CTVNews.ca
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Celiac.com 01/17/2023 - Supply chain shortages and rising prices have hit everyone, but people with dietary restrictions are getting hit extra hard, with extra high prices associated with a shortage of specialty health food products and ingredients. Higher prices for basic ingredients means higher prices for products that use those ingredients. Jennifer Kinkade, the owner of Dedicated gluten free bakery and coffee shop in Tucson, Arizona, says that she's seeing the highest prices ever for specialty ingredients, especially for gluten-free flour ingredients and starches. For example, Kinkade says her price has tripled for ingredients like tapioca starch. “The flours are one of the hardest things right now...gluten free [was] always expensive, but I think it’s even more expensive now,” she said. The supply chain shortages are caused, in part, by labor shortages in the wake of Covid-19. Labor shortages mean farmers must now carefully choose which crops to grow, which they can easily harvest and get to market in the face of labor challenges. The overall effect of the shortage has meant scarcity of products and ingredients, higher prices, and even changes to product ingredients that mean they are no longer gluten-free. In many cases, companies can't get the gluten-free ingredients necessary to make their products. In some cases, that means they're using non-gluten-free ingredients, so some products are no longer gluten-free and safe for people with celiac disease. The short takeaway is that things won't likely improve until the labor shortage improves. Until then, high prices and scarcity of gluten-free products will likely be the norm. Have you experienced scarcity of gluten-free products, sky-high prices, or a change in gluten-free status of a product? Share your story in the comments below. See more at kold.com
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Celiac.com 10/15/2020 - A team of researchers recently conducted an analysis of US healthcare resource utilization (HRU) and costs between celiac patients and a group of matched control subjects. The research team included Katherine Cappell, PhD; Aliki Taylor MPH, PhD; Barbara H. Johnson MBA; Steve Gelwicks, MS; Song Wang, Song PhD; Michele Gerber, MPH, MD; Danial A. Leffler, Daniel MD. They are variously affiliated with the IBM Watson Health, Cambridge, Massachusetts, USA; Takeda Pharmaceuticals International, London, United Kingdom; Takeda Pharmaceuticals International Co, Cambridge, Massachusetts, USA; and the Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA. For their study, the team used the MarketScam databases to isolate celiac patients with an endoscopic biopsy and two or more medical encounters with a celiac disease diagnosis between January 1, 2010, and October 1, 2015. As an index date, the team used the date of the first health claim with a celiac diagnosis on or after the endoscopic biopsy. They matched celiac disease cases 1:1 to with non-celiac patients on demographic characteristics and Deyo-Charlson Comorbidity Index score. The team compared clinical characteristics, all-cause, and celiac-related HRU, and price adjusted costs, between celiac patients and control subject during the one year before and two years after the index date, and matched 11,008 study subjects to 11,008 controls. Study subjects averaged about 40 years old, and just over 70% were women. The follow-up data showed that celiac patients had higher rates of all-cause and celiac-related HRU including inpatient admissions, emergency department visits, gastroenterologist visits, dietician visits, endoscopic biopsies, and gastroenterology imaging. Incremental all-cause costs were nearly $8,000 first year, and $4,000 second year, while celiac-related costs were nearly $3,000 and more than $900 for the same periods. This analysis shows that people with celiac disease face higher all-cause and celiac-related HRU costs, compared with matched non-celiac patients, and helps to quantify the extra financial challenges faced by people with celiac disease. Have you or a loved one faced higher health care costs due to celiac disease? Please share your story below. Read more at the American Journal of Gastroenterology
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Celiac.com 06/01/2020 - People with inflammatory bowel diseases like Crohn’s disease and ulcerative colitis (UC) can have difficulty determining when their symptoms are worsening, which can make them prone to more complications and hospitalizations, according to Lawrence Kosinski, MD, founder and chief medical officer of SonarMD. That can mean highly variable per patient costs, higher overall costs, and more intense patient management, according to data from DDW. Kosinski and colleagues suggest that profiling chronic gastrointestinal diseases by gauging volatility based on cost might offer a hedge against this volatility, in much the same was as it does on the stock market. “Like stocks in the stock market, diseases can be profiled by their volatility...Variability drives cost for these diseases...Some diseases have high variability (high beta), whereas others have low variability (low beta)...The higher the variability (beta rating), the higher the overall cost/patient,” says Kosinski. To calculate an index and beta rating for chronic gastrointestinal diseases, the researchers used data from nearly 41,000 members of the Health Care Service Corporation, such as professional, facility and pharmacy claims for calendar year 2017. From that data, they were able to calculate an index and beta rating for GERD, peptic ulcer disease (PUD), gastritis, celiac disease, pancreatitis, irritable bowel syndrome, Crohn’s disease, UC, colon polyps and diverticulitis. They began by calculating the total disease specific cost for each condition, and used it to build a GI Disease Index with the total disease specific cost for each GI condition, which they separated into deciles. When they determined the cost per decile for each condition, and compared that with the GI index, they found strongly positive beta scores in celiac disease and UC, but in no other GI conditions. The team notes that less variable conditions have more predicable costs and outcomes, and so may be better suited for bundled payments and more episodic care. According to Kosinski, value-based programs with a focus on care coordination, patient engagement and disease management, can improve care and lower costs, high beta conditions. The team is encouraging insurers and gastroenterologists "to work together to engage patients with high beta conditions, track symptoms, catch deterioration early, and intervene before it becomes a bigger problem,” he said. The result could be healthier patients and better bottom lines for everyone. Stay tuned for more on this and related stories. Read more at Healio.com
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Celiac.com 01/09/2014 - Not much is known about costs associated with celiac disease. A team of Israeli researchers recently studied the costs in patients diagnosed with celiac disease. The research team included A.D. Heymann, M. Leshno, R. Endevelt, and R. Shamir of the Medical Division at Maccabi Healthcare Services in Tel Aviv, Israel. They conducted a retrospective case control study covering the period 2003-2006 in a large Israeli Health Maintenance Organization with over two million members. Their study group included 1,754 patients with celiac disease and a control group of 15,040 non-celiac patients. They calculated costs individually for each member, and aggregated costs according to main cost-branches. They conducted a linear step wise regression with costs as the dependent variable and age, gender and the presence of celiac disease as the independent variables. They then compared costs for patients with celiac disease with costs for patients suffering from other chronic diseases. The team found that the total costs of celiac disease patients were significantly higher than those for the control group for hospital admission, medications, laboratory and imaging. The overall hospital admission rate of celiac patients was 7.98% as opposed to 7.1% for the control group (p = 0.06). However, compared with other chronic illnesses, the costs of patients with celiac disease were similar to those of patients with diabetes and hypertension. This study does conclude that celiac disease patients do use more medical services than the general population, at rates likely higher than previously thought. Source: Health Econ Rev. 2013 Nov 7;3(1):23. doi: 10.1186/2191-1991-3-23.
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Higher Medical Costs for People with Celiac Disease
Jefferson Adams posted an article in Additional Concerns
Celiac.com 08/08/2011 - In the face of steadily rising numbers of people with celiac disease, very little information exists on the economic costs and impacts associated with celiac disease. A team of researchers recently set out to assess the impact of celiac disease diagnosis on health care costs and the incremental costs associated with celiac disease. The research team included K. H. Long, A. Rubio-Tapia, A. E. Wagie, L. J. Melton III, B. D. Lahr, C. T. Van Dyke, and J. A. Murray. They are affiliated variously with the Division of Health Care Policy & Research, the Division of Gastroenterology and Hepatology, the Division of Epidemiology, and the Division of Biomedical Statistics and Informatics at the College of Medicine of the Mayo Clinic in Rochester, Minnesota. To carry out their population-based cohort, the team used administrative data on celiac disease cases and matched controls from Olmsted County, Minnesota. They compared: 1) direct medical costs one year before and one year after celiac disease diagnosis for 133 index cases and for control subjects; and 2) cumulative direct medical costs over four years for 153 index celiac cases and for control subjects. Their analyses did not include diagnostic-related and outpatient pharmaceutical costs. They found that a diagnosis of celiac disease lowers the average total costs by $1,764 in the year following diagnosis (pre-diagnosis cost of $5,023 vs. $3,259; 95% CI of difference: $688 to $2,993). They found also that, over a 4-year period, people with celiac disease faced an average of $1,457 in higher outpatient costs (P = 0.016), and an average of $3,964 in higher total costs of $3,964; (P = 0.053), compared with the control group. Men with celiac disease bore the brunt of those higher costs, with excess average total costs of just over $14,000 compared to costs of $4,000 for male controls; 95% CI of difference: $2,334 to $20,309). Costs associated with celiac disease pose a significant economic burden, especially for men with the disease. Early detection, diagnosis and treatment of celiac disease lowers medical costs, and will likely benefit patients and health care providers alike. Source: Alimentary Pharmacology & Therapeutics, Volume 32, Issue 2, pages 261–269, July 2010- 1 comment
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