Celiac disease is a chronic immune-mediated disease that occurs in genetically predisposed individuals after the intake of gluten, a protein present in wheat and other cereals. This condition causes intestinal injury that can impair nutrient absorption, giving rise to a variety of symptoms. The essential therapy for celiac disease is to eliminate gluten from the diet for life. For this reason, the provision of gluten-free foods was included in the essential levels of health care by the ministerial decree of 8 June 2001 and subsequently by law 4 July 2005, n. 123, which widely protects celiacs and provides specific interventions to promote health education, early diagnosis and training of healthcare personnel.
Among the interventions to support celiacs, there is the free provision of substitute food through vouchers provided by the National Health Service. In Valle d’Aosta, patients have long complained that they can only purchase these products in a limited number of shops, mainly pharmacies, where the costs are higher and the voucher is insufficient to cover their needs. This criticality was confirmed by the Health Councilor, who highlighted that only two affiliated businesses, other than pharmacies, are present in Valle d’Aosta: one in Aosta and the other in Donnas.
The Health Councilor of the Autonomous Region of Valle d’Aosta Carlo Marzi, during the discussion in the Valle Council on 25 July 2023, underlined that the low interest of operators in providing food for celiacs is due to two factors: the small size of the market of reference and the need to comply with a digitalized management model, which entails additional tasks for commercial activities.
To address these problems, the Lega Vallée d’Aosta has prepared (reproducing the law in use in Trentino Alto Adige) a regional law proposal which intends to guarantee celiacs the right to the free provision of dietary therapeutic products. The law provides that the Autonomous Region of Valle d’Aosta assigns to celiacs a fixed annual sum, paid monthly by the Local Health Authority of Valle d’Aosta, intended for the purchase of gluten-free products from any retailer, including specialized shops, large organized distribution, pharmacies, parapharmacies and online purchasing sites. In practice, the voucher, instead of being loaded onto the health card, would be paid into the patient’s current account.
This proposal aims to achieve several objectives: making citizens responsible for their health, simplifying access to services, increasing the purchasing power of beneficiaries thanks to the lower costs of products in large-scale retail trade and facilitating access to gluten-free products, improving the quality of life of patients.
The bill is divided into three main points. Article 1 establishes the objective of promoting assistance to celiacs and their normal inclusion in social life. Article 2 extends the usability of the contribution recognized to celiacs for the purchase of dietary therapeutic products, including large-scale organized distribution and online purchasing sites, and assigns the Regional Council the task of establishing the methods and limits for the provision of these economic benefits. Finally, article 3 provides for the financial invariance clause, ensuring that there is neither an increase nor a decrease in the amount of the contribution currently calculated.
The proposal was presented on the symbolic date of May 16, 2024, International Celiac Disease Day.
Written by: Laura Agostino
