Hospital

Specials & Special Obtains


Specials

What are Specials?

Specials are unlicensed medicines created for patients for whom there is no existing suitable licensed product available, for reasons of formulation and/or presentation.

Reasons for unsuitability may include:

  • Allergies to conventional ingredients
  • A unique combination of ingredients
  • Unacceptable presentations e.g. flavours, dysphagia,

Doctors often prescribe compounded medications for reasons that include (but are not limited to) the following situations:

  • When needed medications are discontinued by or generally unavailable from pharmaceutical companies, often because the medications are no longer profitable to manufacture, or there are 'manufacturing/procurement' difficulties for certain products
  • When the patient is allergic to certain preservatives, dyes or binders in available off-the-shelf medications
  • When treatment requires tailored dosage strengths for patients with unique needs (for example, an infant)
  • When a compounder can combine several medications the patient is taking to increase compliance
  • When the patient cannot ingest the medication in its commercially available form and a Specials manufacturer can prepare the medication in cream, liquid or other form that the patient can easily take; and when medications require flavour additives to make them more palatable for some patients, most often children.

When pharmacists and consultant doctors turn to custom-compounded preparations for their patients, they turn to IPS Specials for quality, a broad selection, world-class customer care and fast delivery. When off-the-shelf medicines are not working or tolerated, we provide an array of specialised preparations, including combination therapies; these bespoke preparations are delivered next day.



How to order Specials?

At IPS Specials, you'll find an industry leading team of pharmacists, compounding and dispensing technicians and customer care specialists whose job it is to ensure that you and your patients receive the highest quality preparations exactly as you ordered.

Contact our Customer Service Team today:

  • Call our customer Service Team on: 0800 644 0747
  • Order online at www.myipsspecials.com
  • E-mail our Customer Service Team: orders@ipsspecials.com
  • Fax your order to: 0800 783 0305

Customer care specialists and consulting pharmacists are available: Monday - Friday 9:00 a.m. to 6:00 p.m.
Order your Specials by 5.00pm for next day delivery. Same day delivery available on request.



Why use a specials manufacture?

In June 2011, RPS released their guidance document “Pharmaceutical Issues when Crushing, Opening or Splitting Oral Dosage Forms” along with an update on “GOOD PRACTICE GUIDANCE ON: The Procurement and Supply of Pharmaceutical Specials” relating to their “Dealing with Specials” featurette.  The full guidance can be found on the RPS Website.

IPS Specials has identified the main concerns regarding crushing, splitting and opening capsules from the guidance as:

  • Healthcare professionals or carers being exposed to health risks through powder aerosolisation
  • Irritation if the drug was inhaled or came into contact with eyes, skin or other mucous membranes and, in some cases, causing skin toxicity
  • Negative impact on the stability of the drug substance
  • Less drug available to produce the desired clinical effect (e.g. through powder loss or uneven split)
  • Loss of protection of the drug from the effects of light
  • Changes in the drug pharmacokinetics & bioavailability resulting in underdosing or adverse effects
  • May cause oesophageal or stomach irritation or ulceration if tablets are crushed or capsules opened
  • Refusal of taking the medication due to unpleasant taste
  • Possible anaesthetic effect on the tongue, particularly if sertraline is given in a powdered form
  • Potential of an unintended large bolus dose being delivered rather than controlled release over the intended timescale resulting in a potentially toxic dose with an increased risk of adverse effects
  • Crushing enteric coated tablets may result in the drug being released too early, destroyed by stomach acid, or irritating the stomach lining

Another key consideration for Pharmacists who are being advised to split, crush or opening tablets and capsules is that the NPA Insurance does not cover members should there be any adverse effects**

Above all else, it is imperative that Pharmacists make the CARE OF PATIENTS YOUR PRIMARY CONCERN.   Of course, IPS Specials takes this very seriously and all of our Specials are manufactured in our cGMP-compliant and MHRA-licenced facility, each accompanied with a Certificate of Compliance.  If an imported licenced product is ordered, we will source this from an MHRA recognised authority such as Europe, USA, Canada or Australia though our comprehensive supply chain.

All information has been extracted from the RPS documents mentioned above and are meant as a condensed summary of concerns raised by the RPS - we strongly advise full reading of the documents, including the case studies contained within, which can be obtained by visiting www.rpharms.com/best-practice/specials.asp.  The RPS does not recommend or endorse any company and has not endorsed IPS Specials for this article.
**Look for the Specials and NPA Insurance document (January 2011) in the NPA Member’s area www.npa.co.uk/Resources/



Pharmacists Responsibilities

The Royal Pharmaceutical Society has published guidance to pharmacists on their responsibilities in relation to Specials.

To take all reasonable steps to ensure that:

  • Patients receive medication that is safe, effective, appropriate for their condition and their circumstances, with minimal clinical risk
  • A Special is supplied only when there is no available licensed medicine which fully meets the patient’s clinical needs
  • The appropriateness of continued prescription of a Special is reviewed and that continued supply is justified by continued Special clinical need
  • Any Specials product supplied is fit for purpose – is of the appropriate quality and clinically appropriate for the individual patient
  • They understand their professional responsibilities when supplying Specials i.e. ensure the patient receives a medicine of assured quality

They minimise risk to patients and themselves: the expectation is that pharmacists will supply an unlicensed product only by exception and with the full knowledge of the prescriber and the patient

A pharmacist shares with the prescriber, accountability for supplying a Special to a patient. They must be able to demonstrate that they have acted with due diligence in regards to patient safety, and that they have taken all reasonable steps to ensure:

  • Procurement from an appropriate source
  • That the product is of appropriate quality
  • That the product meets the particular clinical needs of the patient: this may require dialogue with the manufacturer, and if relevant the hospital pharmacy, about all criteria such as formulation and strength
  • That relevant records are kept

What documents to keep on record

It is recommended to keep the following records for a minimum of 5 years:

  • A record of the purchase and supply of a Special and the specification of the product agreed with the supplier should be documented and kept on file in the pharmacy
  • Documentation to verify the specifications i.e. certificate of analysis or a certificate of conformity from the manufacturer, should be obtained on delivery and must include the batch number and expiry details of the product kept on file in the pharmacy
  • Patient details, such as name and address linked to the Special should also be maintained to provide an adequate audit trail
  • The source of the product i.e. manufacturer details
  • The quantity of each sale or supply
  • The batch number and expiry date of the product (listed on certificate of analysis or a certificate of conformity)
  • If the product is in response to a prescription, the records must also include the patient’s details, prescription details and the date of dispensing
  • The date the product was supplied (as may differ from the date of manufacture)

Special Obtains

What are Special Obtains?

Special Obtains are difficult to source items which are generally not available from mainline wholesalers. These include:

  • Made to measure and compression hosiery
  • Specialist dietary foods e.g. gluten free
  • Stoma appliances
  • Homeopathics
  • Derma-cosmeceuticals
  • Incontinence appliances
  • Medical dressing and bandages

This is where IPS Specials steps in. We strive to go that extra mile and assist community and hospital pharmacists in sourcing and delivering products that help meet individual patient needs.  
By working closely with a growing network of over 200 supply partners, our reliable and friendly ‘Special Obtains Sourcing (SOS)’ team takes the hassle out of prescription queries and saves you valuable time and effort by sourcing and procuring these items on your behalf.
Depending on stock availability, Special Obtains are delivered directly to your pharmacy in just 3-5 working days.

How to order Special Obtains?

It’s quite simple really – give us a call or send an email if you need to track down an unusual or difficult to obtain product. We’ll take care of the rest. Contact our Specials Obtains Team today:

Special Obtains Tel: 0208 481 9724
Special Obtains Fax: 0208 481 9723
Special Obtains Email: SOS@ipsspecials.com


Call us now 0800 644 0747
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