Chains and independents now speak with one voice

Noting the myriad challenges facing community pharmacy, ranging from changes in the Medicare program to the growth of mandatory mail-order programs, Rosato argued that chain and community pharmacies need to work together and speak with one voice. In fact, the industry's inability to work together in the past had serious repercussions for community pharmacies. The passage of the Medicare Modernization Act, Medicare Part D prescription drug benefit, and the Deficit Reduction Act "were huge issues and huge losses for us," she remarked. "We realized that community pharmacy was very fragmented, which is why our voice was not heard."

Taking those lessons to heart, NACDS has joined with the National Community Pharmacists Association to create the Coalition for Community Pharmacy Action (CCPA). The first challenge, Rosato noted, was to prevent the Department of Defense's Tricare healthcare system from requiring mandatory mail order. When the House of Representatives and Senate passed different versions of the National Defense Authorization Act this summer, the two versions differed significantly-especially on the issue of whether recipients should be required to use mail-order pharmacies. When the final version was announced in October, "it was truly a first victory for community pharmacy in a long, long time," she reported. "We still have work to do, but we feel very good that through CCPA and the grassroots effort, we had success."

According to Rosato, another key organization working toward uniting the pharmacy industry is the Pharmacy Quality Alliance. PQA is an industrywide organization that seeks to improve healthcare quality and patient safety through a collaborative process in which key stakeholders agree on a strategy for measuring performance at the pharmacy and pharmacist levels to improve outcomes and stimulate the development of new payment models.

"This is where the future of pharmacy must go," Rosato argued. "We can no longer be commoditized and focused strictly on product cost. We have to step up to the plate and show that we provide value through services to help patients understand their medications and remain compliant."

The adoption and preparation for electronic prescriptions is another initiative uniting community pharmacy. NACDS and NCPA joined together in 2001 to create SureScripts, and 95% of community pharmacies and 25% of physician practice sites are now certified to use the SureScripts network. The federal government has mandated adoption of electronic prescribing by 2010. "At least pharmacy is being visionary about this and looking at this as another opportunity to show its value, reduce medication errors, and increase patient safety," Rosato declared.