Three-dimensional printing can vary drug dose, geometry, composition, internal architecture, release characteristics, and patient-facing features with a degree of flexibility that conventional mass manufacture rarely provides. Yet technical customizability does not by itself establish that a resulting medicine is patient-specific. A clinically individualized product must retain a defensible relationship between the patient's therapeutic requirement and the attributes deliberately changed during manufacture. That relationship becomes vulnerable when dose modification alters release, when material or process variability changes product performance, when manufacturing instructions are detached from the authorized prescription, or when the dispensed unit cannot be linked reliably to its quality and production record. This Perspective examines patient specificity as a property of the complete manufacturing-use case rather than of printing technology alone. It distinguishes clinical specification, biopharmaceutical fitness, formulation and process control, release assurance, dispensing identity, and traceability as separate conditions that can succeed or fail independently. Clinical studies show that individualized printed medicines can be prepared and used in selected settings, but current evidence remains product-, technology-, and context-dependent. A defensible claim of patient specificity therefore requires more than a customized geometry or nominal dose: the intended therapeutic change must survive design, manufacture, verification, release, and dispensing without losing its clinical meaning.
