Audit of Six Ulcer Treatment Drugs Reimbursed Under the Pennsylvania Medicaid Prescription Drug Program

The OBRA '90 requires State Medicaid agencies to assess drug use review programs on an ongoing basis. These programs are intended to assess actual patient drug use against predetermined standards. One of the standards recognized by OBRA '90 is manufacturers' recommended dosages. Our review showed that about $6.53 million (Federal share $3.71 million) in cost savings could have been realized for Calendar Year 1990 had the State agency limited payment for these drugs to the amount needed to pay for the manufacturers' recommended dosages.