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  1. Explore gray areas:
    Check medications to see if there are gray areas or questions about whether an expensive drug is indicated or whether an expensive drug is indicated or whether a less expensive alternative with the same efficacy and safety could be substituted. 
  2. Identify drugs that have gone up in price:
    Develop a data analytics tool that alerts pharmacy staff to significant spikes in pricing so they can work with clinicians to rapidly identify lower-cost options. The tools could also calculate the financial impact to the hospital based on annual usage of the drug.
  3. Negotiate volume discounts:
    Using the process of therapeutic interchange — in which pharmacists and doctors identify a few drugs in each drug class that will be used exclusively by the hospital  you can seek discounts on your first-line drugs through a GPO that negotiates prices directly with a drug manufacturer.
  4. Manage drug inventories:
    Maintain tighter control over automated dispensing cabinets on nursing units. Weed out unused, duplicate and low-use drugs from storage areas.
  5. Try extended dating:
    Work in tandem with an analytical labaratory to test the stability of some medications and extend their expiration dates.
  6. Use consignment services:
    Identify certain high-cost, low-use drugs and partner with a consignment service to have these drugs delivered on an as-needed basis, rather than storing them in house.
  7. EHR transparency tools:
    Build an alert system into your EHR that can prompt physicians at the point of prescribing medications to explore other similar drug options. Similar drugs are rated by costs so physicians know exactly what the cost of the drug is that they are prescribing.