Trainee dispensing assistant Georgia is talking to pharmacy technician Vicky.
“I was wondering,why aren’t specials used more?” Georgia replies.
“What do you mean?” asks Vicky. “You always complain about having to order them!”
“Well, yes, it’s a pain from our point of view,” agrees Georgia. “But from the patient’s side of things, they are ideal, aren’t they? It’s like my boyfriend getting a suit from a tailor instead of going into a shop to buy one – it’ll fit so much better because it’s made specifically for him. It’s the same for specials surely? With so many medicines not taken and wasted, wouldn’t it be better for people to get something that is exactly right for them in terms of liquid versus tablet, flavourings and other ingredients for allergies – all of that kind of thing?”
Georgia’s argument is persuasive, but there are a few counter-arguments to her points, including the fact that specials – bespoke medicines – are unlicensed. This means that although manufacturers have to adhere to Good Manufacturing Practice (GMP) standards, they don’t have to provide evidence of quality, safety and efficacy in the same way that they would have to when obtaining a license for a particular product from the Medicines and Healthcare products Regulatory Agency (MHRA).
Furthermore, specials are usually considerably more expensive than their licensed equivalents and, because they are made to order, they can take some time to reach the patient compared to medicines that can be picked off the shelf, or even ordered from a wholesaler for the same- or next-day delivery. In many cases, this delay to treatment – particularly for a new or urgent medicine – is unacceptable.
The MHRA has published a hierarchy for the use of unlicensed medicines:
The MHRA states that the above hierarchy is for guidance only, and stresses the importance of considering every case on an individual basis.