The unbearable cost of being gluten-free: rethinking celiac disease screening

The recent analysis by Gianolio and colleagues provides a crucial economic and organizational assessment of Italy's emerging pediatric screening program for celiac disease (CD) [1]. While their model assumed screening at ages 2, 6, and 10, revealing significant long-term costs dominated by lifelong gluten-free diet (GFD) subsidies; the official Ministerial Decree establishes a different framework with a single screening round at ages 5–6 years [2]. This streamlined approach reduces initial logistical challenges but introduces distinct economic considerations while overlooking the substantial burden of undiagnosed CD in adults.