“Specials are unlicensed medicinal products manufactured in the UK for human use which have been specially prepared to meet a prescription ordered for individual patients without the need for the manufacturer to hold a marketing authorisation for the medicinal product concerned.” - The Drug Tariff
Specials are often prescribed when a liquid is needed. They are often very costly and on many occasions there are licensed alternatives that could be used instead.
This page contains specials data showing which items have been prescribed by each practice and how much they cost. Please check this data to see whether an alternative could be used instead. There are supporting documents which show what alternatives medicines could have been prescribed.
To help guide prescribers on alternatives available when a patient has swallowing difficulties or enteral feeding tubes the IESCCG is now providing access to the NEWT guidelines. These guidelines can be found at www.newtguidelines.com. Please contact the medicines management team for your username and password.
The following resource, used with permission from Derbyshire CCG, provides an alphabetical list of alternative medications which could be used and is designed to aid prescribers reviewing unlicensed (specials) medication.
Specials and Expensive Liquids Guideline June 2019
For a small number of medicines, there are differences in equivalent doses of oral formulations of the same medicine. The link below provides guidance on medicines that may require dose adjustment when switching between oral formulations (Document updated July 2020 by UKMI/SPS).
Switching between liquid and tablet capsule formulations - which medicines require extra care
For an example patient letter (to be used when medication is switched from a special to a licensed product) click here
(Click above link)
If you have any queries please do not hesitate to contact the team on:
Tel.: 01473 770249