We at the National Community Pharmacists Association (NCPA) are placing a high priority this year on cooperative efforts and coalition building with other organizations to help broaden community pharmacy's reach with legislators, regulators, and policy makers.

There is, of course, our joint government affairs venture with the National Association of Chain Drug Stores (NACDS) in the Coalition for Community Pharmacy Action (CCPA). The coalition has been quite active in arranging visits by senators and representatives to community and pharmacies this summer and fall to demonstrate to lawmakers what front-line pharmacists do for their patients and face with pharmacy benefit managers every day.

Last winter, we worked to simplify and standardize Part D electronic claims messaging with NACDS and America's Health Insurance Plans (AHIP), the trade association that represents nearly 1300 insurers who cover >200 million Americans. Along with AHIP, NACDS, and the Centers for Medicare & Medicaid Services (CMS), we are founding members of the Pharmacy Quality Alliance. While its primary goal is to develop strategies for defining and measuring pharmacy performance, then-CMS chief Mark McClellan, MD, PhD, noted, "We also expect that this could lead to new pharmacy payment models for optimizing patient health outcomes."

Our latest coalition involves a Medicare policy that could drive patients with diabetes away from the community pharmacies where they now receive the kind of personalized treatment and concern that keeps them active, healthy, and out of hospitals. Simply put, Medicare wants to lump self-monitoring blood glucose systems, including meters, strips, and lancets, into the same competitive bidding/supplier accreditation category as durable medical equipment items such as power wheelchairs, hospital beds, and walkers.

There simply is no comparison, which is why NCPA, NACDS, the American Association of Clinical Endocrinologists, and the American Association of Diabetes Educators established the Diabetes Access to Care Coalition. We want Mike Leavitt, secretary of Health and Human Services, to use his authority under law to exempt the medical technology that empowers the 21 million Americans with diabetes to easily monitor their blood sugar levels as directed by their physicians.

Accreditation for state-licensed pharmacists is unnecessary, time-consuming, and expensive. Many of our members are telling us that it is not worth it to them to get accredited just so they can bid to sell such low-cost products as test strips.

Requiring accreditation and competitive bidding for pharmacy supplier participation would impose prohibitive costs in terms of money and time (an estimated $7000-$17,000 and 70 hours just to achieve initial accreditation and bid).

Any policy that limits the ability of patients to access products from the community pharmacies that help them manage their diabetes is shortsighted and potentially deadly. That is why our latest coalition is working hard to convince the Bush administration and Congress to avoid disaster.

Mr. Roberts is executive vice president and chief executive officer of the National Community Pharmacists Association.

The Coalition for Community Pharmacy Action (CCPA) is an alliance between the National Association of Chain Drug Stores (NACDS) and the National Community Pharmacists Association (NCPA), which together represents more than 55,000 community pharmacies. CCPA leverages the support, effort, and infrastructure of NACDS and NCPA while engaging community pharmacy to participate and advocate on issues affecting the industry.