Most drugs prescribed for patients as part of their NHS treatment are licensed medicinal products. However, there are rare occasions when a patient needs a formulation or strength that is not available as a licensed form, or needs to avoid ingredients that provoke allergy. To address such needs, many specially prepared products are produced by specialist manufacturing units. These so-called ‘specials’, unlike licensed medicines, are not assessed for safety or efficacy by a regulatory body.1 Prescribers are often unaware of the costs of specials. Here we explore some of the issues associated with specials in primary care and whether their use represents good value for money.
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