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

This final report presents the results of our review of six ulcer treatment drugs reimbursed under the Illinois Medicaid prescription drug program. The Omnibus Budget Reconciliation Act of 1990 (OBRA '90) requires the State Medicaid agencies to operate drug use review programs on an ongoing basis. One of the standards recognized by OBRA '90 is the manufacturers' recommended dosages. We concluded that the Illinois Department of Public Aid (State agency) did not have any restrictions pertaining to the manufacturers' recommended dosages for ulcer treatment drugs. Accordingly, our review showed that about $5.82 million (Federal share $2.91 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.