Wednesday, 23 February 2011

Comment on article in Daily Mail Good Health

25th January 2011

Following a recent article in the Daily Mail the ACSM, Association of Commercial Specials Manufacturers, is keen to reassure patients of the need for specials or unlicensed medicines.   The article raised questions about the necessity of providing specially prepared liquid forms of common medicines for some patients. 

Although the ACSM cannot comment on the details of the drug preparation in the article, in general, unlicensed medicines are prescribed by a doctor to meet a patient’s specific clinical need, for example, allergy to drug excipients or inability to swallow. 

In these instances a doctor may decide to prescribe a special if there is no licensed alternative available to give to the patient.  Splitting and crushing tablets is not a satisfactory alternative as it does not always result in the patient receiving the correct formulation leading to a patient getting a much higher or much lower dose than is prescribed.

Anyone who has concerns about the need for their Special prescription is encouraged to talk to their doctor or pharmacists for advice and guidance but should not attempt to formulate their own medicines.


The ACSM, whose members produce a large proportion of the Specials manufactured in the UK, has been consulting with the Department of Health (DH) about a method of controlling the cost of Specials that doesn't compromise the supply to vulnerable patients. As outlined in the article below (Chemist and Druggist), the ACSM looks forward to a solution this year.

The current market structure makes it possible to re-sell Specials through a distribution chain over which neither the original manufacturer nor the NHS has control. In this way, the reimbursement price paid is sometimes decided further down the distribution chain and can be significantly different from the original ex-factory prices.

The ACSM, Association of Commercial Specials Manufacturers, believes resolution will lead to greater transparency within the sector and help eliminate the potential for excessive price inflation within the distribution chain which has affected the industry’s reputation. ACSM members are concerned that negative media attention could threaten the supply of to vulnerable patients in the long term if confidence is not restored in the sector.