As the ISMP LASA list or Confused Drug Name list has grown exponentially over the years and manufacturers are allowed to make identical looking products without repercussions how have healthcare systems responded?

We are doing all the typical interventions like BCMA, automation, order sets, inventory separation, TALLman lettering, etc. but it is becoming more difficult to stay on top of LASA meds, especially the look alike product issue. Going through the Confused Drug Name list and deciding what is relevant or not has also proved more challenging and time consuming. To me the value of the list has diminished. Has anyone come up with a strategy to rank the list by the risk of potential patient harm while keeping in mind the settings where the medications are encountered ? Have others implemented processes in the procurement stage to identify look alike medications as they come in so they can either be separated physically or a different manufacturer obtained? Other approaches?

My feeling is the industry needs a more robust presentation of Confused Drug Names beyond a static list and we at the site level need another slice of cheese that is more reliable than catching reports from others in ISMPs on medications that look similar.