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Named Patient Basis

All medications in the UK are regulated by the Medicines and Healthcare products Regulatory Agency (MHRA).  The MHRA is the Government agency which is responsible for ensuring that medicines and medical devices work, and are acceptably safe. Manufacturers must obtain marketing authorisation for any medication that they want to sell.

All major medications that are licensed in this country will be found in the Monthly Index of Medical Specialities (MIMS), which is an independently written publication designed as a prescribing guide for general practitioners. Generally, if the medication your doctor wants to prescribe is not in the MIMS, then he will not prescribe it.

However, there is an exception to the rule. Some medications can be prescribed on a “named patient” basis. This means that, in certain circumstances, your doctor can prescribe this medication because the patient has a special need.

Reasons why drugs may be supplied on a “named patient” basis are:

  • a license has not been granted yet due to ongoing clinical trials
  • discontinuations
  • drug shortages
  • temporary supply problems
  • clinical trials
  • special needs of an individual patient

Non-UK brands of medicines are classed as “unlicensed medicines” because they are not manufactured in the UK. These can also be prescribed on a “named patient” basis.

A document published by the Medicines and Healthcare Products Regulatory Agency (MHRA) – “The supply of unlicensed medicinal products (“specials”)” states,

“An unlicensed medicinal product may only be supplied in order to meet the special needs of an individual patient. An unlicensed medicinal product should not be supplied where an equivalent licensed medicinal product can meet the special needs of the patient. Responsibility for deciding whether an individual patient has “special needs” which a licensed product cannot meet should be a matter for the doctor, dentist, nurse independent prescriber, pharmacist independent prescriber or supplementary prescriber responsible for the patient’s care. Examples of “special needs” include an intolerance or allergy to a particular ingredient, or an inability to ingest solid oral dosage forms. These examples are not exhaustive 167(2)-(8).”

If you don’t feel well or you have adverse reactions to the UK generic levothyroxine or liothyronine discuss with your doctor the possibility of being prescribed a non-UK brand under the above exemption.

You will find at the moment that liothyronine in the UK is extremely expensive but if your doctor is willing to prescribe a brand from outside of the UK, this will save the NHS money.  However, this can only happen on a “named patient” basis.

Because none of the natural desiccated thyroid hormones is licensed in this country, you will not find this medication in the MIMS and the only way you can obtain this is by your doctor prescribing it on a “named patient” basis.

If your doctor is willing to give you a prescription for a brand of natural thyroid hormone, you should be able to take it to any High Street pharmacy such as Boots, Lloyds etc. or any local independent pharmacy. 

Ensure that your doctor has written the name of the medication along with the number of grains required and the wording, “for hypothyroidism ” on the prescription.   Some wholesalers ask for a “letter of clinical need.”

To obtain thyroid medications that are not manufactured in the UK, your chemist will need to find a wholesaler who has a license to import medications on a “named patient” basis.  Thyroid UK has published a list of wholesalers and pharmacies.  You can also use this list to access thyroid medications that your local pharmacy is unable to obtain.

Date updated: 02/02/21 (V1.5) Review date: 15/04/22

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