Organization: Center for Drug Policy, Partners Healthcare Problem or Issue Addressed: The Pharmacy Cost Management Committee of the Partners Healthcare System (PHS), a consortium of seven greater Boston area hospitals, has recognized the need to control the future growth rate of pharmaceuticals by managing the utilization of new, high cost pharmaceutical technologies and learning from best practices across the network and country. The Center for Drug Policy (CDP) was established in August 2007 to provide the analytical resources to support the Pharmacy Directors and multidisciplinary teams of physician and pharmacist content experts in this endeavor. Goals: The major objectives of the CDP are to forecast and manage the introduction of new, high cost pharmaceutical technologies and to streamline the development and implementation of common guidelines across the network. Additional objectives of the CDP are to 1) identify and coordinate cost savings opportunities, 2) conduct prospective utilization reviews and assessment, 3) share best practices across the network, and 4) benchmark against high performance organizations nationwide. Outcomes items used in the decision: Both process and outcome-related measures will be measured. For process-related measures, the number of the following outputs and select intermediate steps will be assessed quarterly: guidelines (drug/ therapeutic class/ disease), budget-impact models, guideline dissemination and implementation, and assessment of guideline impact. Outcome-related measures will be assessed at a global level and a project-specific level. At the global level, annual drug purchases, drug cost/case-mix adjusted discharge, and drug cost/case-mix adjusted patient day will be measured quarterly at each hospital. At a project-specific level, outcomes will depend on the pharmaceutical technology but would include clinical (e.g., adherence to guidelines, time to event, complications, etc.) and economic measures (e.g., volume of drug, length of stay, drug purchases, etc.) Implementation Strategy: To establish the CDP, the CDP leadership met with key stakeholders across the network of hospitals, undertook a targeted literature review of cost management strategies in the hospital setting, and conducted an on-site visit to another hospital's CDP. Access to and training on key data resources including drug purchasing data, computerized physician order entry, and cost accounting systems was obtained. A database to track emerging drug therapies and tools to assist in project management were created. Internal processes and tools were developed to ensure quality, consistency, and documentation of guideline development. To facilitate sharing best practices across the hospital network, presentation opportunities have been provided at monthly CDP meetings; in addition, a monthly memo summarizing key Pharmacy & Therapeutics Committees activities across the network has been prepared and distributed to Pharmacy leadership. Templates for ongoing internal reporting were also developed. Results: As the CDP was established in August 2007, data collection is ongoing; an overview of anticipated results is, however, provided. Using the internal reporting template, the number of process-related measures will be presented. For outcome-related measures, the global metric reporting approach will be described and a reporting template will be shared. An example of a project-specific reporting template will be presented. Lessons Learned: To date, we have learnt that the key steps to establishing a new CDP include early involvement of key clinical expert stakeholders in guideline development, the need to minimize the burden of these clinical experts, and involvement of senior leadership as needed to ensure that progress continues to be made. In addition, collaboration is important to minimize duplication of effort and to increase the efficiency of the CDP. Finally, developing a plan a priori for guideline dissemination, implementation, and assessment is needed.