Persistent price disparities in allergy-friendly foods in Canada: a repeated cross-sectional analysis of retail costs from 2023 to 2026

Abstract Background Food allergy requires strict dietary avoidance, often necessitating reliance on specially formulated allergy-friendly foods. These products are typically more expensive than conventional products and thus contribute to financial burden; however, recent Canadian data on these price differences are limited. Methods A repeated cross-sectional retail price analysis was conducted using products from major Canadian grocery retailers at two time points: January 2023 and January 2026. Allergy-friendly alternatives were defined as items labeled free from at least one selected priority allergen. Prices were standardized per 100 g or 100 mL, and price premiums were calculated relative to conventional products. Results In 2023, 296 products were included of which 276 (93.2%) were available again in 2026. Replacement products were found for 20 items available in 2023 but not in 2026. Allergy-friendly alternatives were significantly more expensive than conventional products in both years (all p < 0.05). Overall, allergy-friendly alternatives had price premiums of 84.1% more in 2023 and 71.2% more in 2026. Price disparities varied by category and were greatest for snacks and cereals. Sensitivity analyses excluding replaced products yielded similar results. Conclusion Allergy-friendly foods remain substantially more expensive than conventional products, despite modest reductions over time, highlighting a persistent and clinically relevant financial barrier to safe dietary management for Canadians living with food allergy.