Pressure to cut specials costs by sourcing them cheaply could lead to a drop in quality, the Association of Pharmaceutical Specials Manufacturers (APSM) has warned.

The APSM said many pharmacists felt under pressure to cut the cost of specials after a survey conducted by the association suggested 40 per cent had been told by PCTs to reduce spend.

The survey of 200 pharmacists revealed that half believed, to save money, specials should be manufactured under section 10 of the medicines act, which allows the medicine to be assembled in a registered pharmacy.

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	And half believed that there was no difference in quality between a special prepared under section 10 and a medicine manufactured in accordance with an MS licence. A quarter of respondents said they had changed the way they sourced specials since the new tariff was introduced in November.

"The section 10 exemption is intended for emergencies and is not subject to the rigorous quality measures required of any special manufactured under an MS license," a spokesperson said.

Responding to the comments, the NPA confirmed that it had seen PCTs pile pressure on pharmacists to reduce medicines spend. Although it had not received many reports in recent months, the support group said it had noticed the issue arising last year, when the new specials tariff was introduced.

"Last year, we received numerous enquiries from pharmacists who were being told by PCTs to source specials from specific companies and directing doctors to specify specials manufacturers on the prescription," said NPA head of pharmacy Leyla Hannbeck.

But contractor Mike Hewitson of Beaminster Pharmacy, Dorset, said he was "dead-set against" specials being produced under section 10. "Manufacturing a product in a pharmacy will never be at a comparable standard to doing it with the right equipment and the right environmental monitoring," he said.

Mr Hewitson added that pharmacists were "taking a risk" by preparing medicines themselves. "You're probably going to be doing this once in a blue moon," he argued. "Are pharmacists' skills really up to the standard that they might have been 10 years ago, when they were doing this once a week?"