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The Economic Burden of Food Allergy

IRELAND

NORTHERN IRELAND

For the first time on the island of Ireland, novel research findings have provided data and evidence on the socio-economic costs of living with a food allergy, food intolerance or coeliac disease. Our main finding is that if you live in Ireland with a food hypersensitivity – it’s going to cost you!

 

Having grown up living with food allergies, and witnessed first-hand the additional monetary and non-monetary costs associated with it compared to my peers, I was motivated to investigate the financial impact of living with food hypersensitivities with the research teams at Technological University Dublin and Queens University Belfast.

 

Food hypersensitivity is a broad term but for the purposes of this research, it referred to food allergy, food intolerance and coeliac disease.

 

Our aim was to determine the extent to which food hypersensitivity impacts adults and children’s lives, both from a financial and socio-economic perspective.

 

The research revealed that having a food hypersensitivity is a financial burden for individuals and families.

 

For adults with food allergies, this is about €1,600 a year, while for a child it’s just over €1,400 a year. For individuals with Coeliac Disease, the costs are €400-€1000 per year while those with Food Intolerance the costs are up to €500 per year.

We also know from the research that these conditions affect at least one in ten of the population, with symptoms ranging from mild to life-threatening.

The overall findings are in agreement with many published studies in other EU countries, which report higher costs associated with medication, healthcare and travel to see medical professionals as a result of having a food allergy (Voordouw et al., 2010; Fox et al., 2013; Jansson et al., 2014; Cerecedo et al., 2014; Protudjer et al., 2015), and coeliac disease (Long et al., 2010; Violato et al., 2012; Picarelli et al., 261 2014; Cappaci et al., 2018; Lee et al., 2019; Hanci and Jeanes, 2019).

As an individual living with a food allergy, I was not surprised by the research findings. When grocery shopping, I often notice that ‘free from’ food products (free from a particular allergen) may be more expensive than non ‘free from’ food products. I tend to buy whole foods which have a shorter shelf life rather than pre-made convenience meals which may contain allergens, resulting in shopping more regularly with additional preparation and cooking time. Combined with the increase in food costs, we must also consider medication and transport costs to healthcare appointments, hospital admissions and additional health-related arrangements.

From the current news, we can see that the rising global commodity costs and the soaring food prices are affecting people’s ability to buy food and are adding further pressure to low-income households in the EU, but it’s clear that those living with a food hypersensitivity face extra costs on top of those already happening due to rising food and energy prices. The food environment has always presented challenges for those with a food hypersensitivity and their families.

 

Recommendations

There were several recommendations proposed by food allergic and coeliac adults to address these challenges. These included:

  • Financial assistance with healthcare costs

  • Improved access to medical resources, including dietetic support and patient support to ameliorate the quality-of-life impacts

  • Greater access to gluten-free products along with an increase in public and food industry awareness and understanding of food hypersensitivity.

Not only does this research increase broader awareness among the public and food industry about the issue of food hypersensitivity but it is our hope that these findings can be used as the evidence base to help inform policy, guidance and future supports to improve the health and quality of life of those affected by food hypersensitivity and their families.

 

This was a  collaborative project funded by safefood and led by teams from the School of Food Science & Environmental Health, Technological University Dublin and the Centre for Public Health, Queens University Belfast.

 

 

Read the full report on the Safefood website:

The socio-economic cost of food hypersensitivity on the island of Ireland – Safefood | TU Dublin | Queens University Belfast (2022)

 

Project Steering Committee:

Dr Ciara Walsh (Project Co-ordinator and Lecturer, Technological University Dublin) Ms. Eliza Dimla (Postgraduate Student, Technological University Dublin) Dr Stephen O’Neill (Lecturer, London School of Tropical Medicine) Ms Laura Carter (Postgraduate Student, National University of Ireland Galway) Dr Charlene McShane (Lecturer, Queens University Belfast) Ms Eimear O’Rourke (Research Assistant, Queens University Belfast) Dr Katarina Domijan (Lecturer, Maynooth University) Dr James McIntosh (Specialist in Toxicology, safefood) Dr Nadim Akasheh (Medical Consultant, St. James’s Hospital, Dublin) Dr Anne Dee (Public Health Doctor, HSE) Dr Orla Cahill (TU Dublin) Dr Michelle Riblet (Director, Scientific Advisory Services (Agri-Food)) Dr Mary Friel (Director, Marel Consulting)

 

References

  1. Voordouw, J., Fox, M., Cornelisse-Vermaat, J., Antonides, G., Mugford, M., and Frewer, L. (2010). ‘Household costs associated with food allergy: an exploratory study’, British Food Journal, 112(11), 1205-1215
  2. Fox, M., Mugford, M., Voordouw, J., Cornelisse-Vermaat, J., Antonides, G., de la Hoz Caballer, B., Cerecedo, I., Zamora, J., Rokicka, E., Jewczak, M., Clark, A. B., Kowalski, M. L., Papadopoulos, N., Knulst, A. C., Seneviratne, S., Belohlavkova, S., Asero, R., de Blay, 280 F., Purohit, A., Clausen, M., Flokstra-de Blok, B., Dubois, A. E., Fernandez-Rivas, M., Burney, P., Frewer, L. J., and Mill, C. E. N. (2013). ‘Health sector costs of self-reported food allergy in Europe: a patient-based cost of illness study’, European Journal of Public Health, 23(5), 757–762. doi:10.1093/eurpub/ckt010.
  3. Goossens, N. J., Flokstra‑de Blok, B. M., van der Meulen, G.N., Arnlind, M. H., Asero, R., Barreales, L., Burney, P., Cerecedo, I., Clausen, M., Fernandéz-Rivas, M., Frewer, L., de la Hoz Caballer, B., Jansson, S.A., Jedrzejczak-Czechowicz, M., Knulst, A. C., Kowalski, M. L., Papadopoulos, N. G., Purohit, A., Rokicka, E., Starosta, P., Vásquez-Cortés, S., Duiverman, E. J., and Dubois, A. E. (2014). ‘Health‑related quality of life in food‑allergic adults from eight European countries’. Annals of Allergy, Asthma and Immunology, 113(1), 63–68 (e1).
  4. Cerecedo, I., Zamora, J., Fox, M., Voordouw, J., Plana, N., Rokicka, E., Fernandez-Rivas, M., Vázquez Cortés, S., Reche, M., Fiandor, A., Kowalski, M., Antonides, G., Mugford, M., Frewer, L. J., and de la Hoz, B. (2014). ‘The impact of double-blind placebocontrolled food challenge (DBPCFC) on the socioeconomic cost of food allergy in Europe’, Journal of Investigational Allergology and Clinical Immunology. 24(6), 418– 424.
  5.  Jansson, S.A., Östblom, E., Protudjer, J., Arnlind, M. H., Bengtsson, U., KällströmBengtsson, I., Marklund, B., Middelveld, R., Rentzos, G., Sundqvist, A.C., Åkerström, J., Dahlén, S.E., and Ahlstedt, S. (2015). ‘Health-related quality of life in children and adolescents allergic to staple foods’. Clinical and Translational Allergy, 5 (Suppl 3):O23
  6. Long, K.H., Rubio‐Tapia, A., Wagie, A.E., Melton III, L.J., Lahr, B.D., Van Dyke, C.T., and Murray, J. A. (2010). ‘The economics of coeliac disease: a population‐based study’, Alimentary Pharmacology and Therapeutics, 32(2), 261-269
  7. Violato M., Gray A., Papanicolas I., and Ouellet M. (2012). ‘Resource Use and Costs Associated with Coeliac disease before and after Diagnosis in 3,646 Cases: Results of a UK Primary Care Database Analysis’. PLOS ONE, 7(7), e41308. Available at: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0041308&type= printable
  8. Picarelli, A., Di Tola, M., Borghini, R., Isonne, C., Donato, G., De Vitis, I., and Frieri, G. (2014). ‘The High Medical Cost of Coeliac Disease Missed Diagnosis: Is it Cheaper to Suspect it in Time?’. Internal Medicine. 4(3), 155. Available at: https://www.longdom.org/open-access/the-high-medical-cost-of-celiac-diseasemissed-diagnosis-is-it-cheaper-to-suspect-it-in-time-2165-8048.1000155.pdf
  9. Capacci, S., Leucci, A. C., and Mazzocchi, M. (2018). ‘There is no such thing as a (gluten-) free lunch: Higher food prices and the cost for coeliac consumers’, Economics & Human Biology, 30, 84-91.
  10. Lee, A. R., Wolf, R.L., Lebwohl, B., Ciaccio, E.J., and Green, P.H.R. (2019). ‘Persistent Economic Burden of the Gluten-Free Diet’, Nutrients, 11, 399.
  11. Hanci, O., and Jeanes, Y.M. (2019). ‘Are gluten-free food staples accessible to all patients with coeliac disease?’, Frontline Gastroenterology, 10:222–228.
  12. Jansson S.A., Protudjer, J.L., Arnlind Heibert, M., Bengtsson, U., Kallström-Bengtsson, I., Marklund, B., Middelveld, R.J., Rentzos, G., Sundqvist, A.C., Akerström, J., Ostblom, E., Dahlén, S.E., and Ahlstedt, S. (2014). Socio-economic evaluation of well characterized allergy to staple foods in adults. European Journal of Allergy and Clinical Immunology, 69,1241-7.

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