Objective: To validate the therapeutic interchange system at healthcare institutions as new initiatives in the Kingdom of Saudi Arabia. Methods: It is a new initiative project drove by national therapeutic interchange system programs. The projects drove the therapeutic interchange system guidelines and the international business model, pharmacy project guidelines project management institution guidelines of a new project. The initiative project is written through project management professionals and contained of several parts, including the initial phase, the planning phase, the execution phase and the monitoring and controlling phase. Results: The therapeutic interchange services with a defined vision, mission and goals. The services had various aids, including clinical and economical, on patients and the healthcare system, as exemplified in the assessment. The continuation was of the project assured by the risk management model description. Besides, the monitoring and controlling of the services as declared. The transition to operation project, though closing the project stage, explored in the analysis. Conclusion: The therapeutic interchange system is a new initiative, part of the formulary management. There are various therapeutic interchange system classes of medications can be started though antibiotics, gastrointestinal medications and anti-psychiatric medications; it is highly recommended to implement in Saudi Arabia.