Abstract

Objective: The aim of this study was to investigate access to Food for Special Medical Purposes (FSMPs) for patients with Inherited Metabolic Disorders (IMDs) across Italian regions, with a focus on the role of dietitians and the challenges faced in prescription and supply processes.

Subjects and Methods: An online survey of 32 multiple-choice questions was distributed to 38 dietitians affiliated with the Italian Society for the Study of Hereditary Metabolic Diseases and Newborn Screening (SIMMESN). Responses were analyzed using descriptive statistics.

Results: 29 dietitians across 12 regions responded to the survey. Only 48.3% of respondents believe that a standardized regional procedure for FSMP distribution exists, while 51.7% cited district-level variations. Most respondents (86.2%) reported that patients sometimes need to purchase FSMPs independently. Prescription methods varied, with both paper and electronic systems in use. Dietitians played a central role in FSMP selection but had limited authority in administering prescription plans. Bureaucratic delays were common, with over 34% of respondents reporting delivery times exceeding two weeks. Budget limitations and procurement issues further restricted access.

Conclusions: Despite national coverage under essential care levels, disparities in FSMP access persist due to regional policy fragmentation. Enhancing national harmonization, formalizing the role of dietitians, and improving administrative efficiency are critical to ensuring equitable and timely dietary support for IMD patients in Italy.