551 Office of Medical Assistance Programs; Prior authorization of anti-ulcer drugs

Office of Medical Assistance Programs; Prior Authorization of Anti-Ulcer Drugs

[26 Pa.B. 1603]

   The Department of Public Welfare announces that certain anti-ulcer drugs are now subject to prior authorization under the following circumstances:

   1.  When prescribed or dispensed in quantities that exceed the maintenance dosage levels customarily recommended for the treatment of gastric or peptic ulcers after the initial 90 days of acute treatment has passed.

   2.  When duplicate or concurrent treatment is prescribed with more than one anti-ulcer drug at any point in time.

   3.  When a change is prescribed from one ulcer medication to another during the initial 90 day acute stage.

   The affected anti-ulcer drugs, listed by brand name with their generic name in parentheses, are: AXID (nizatidine), CARAFATE (sulcralfate), CYTOTEC (misoprostol), PEPCID (famotidine), PREVACID (lansoprazole), PRILOSEC (omeprazole), TAGAMET (cimetidine), ZANTAC (ranitidine).

   The Department adopts this requirement under section 443.6(b)(7) of the Public Welfare Code (62 P. S. § 443.6(b)(7)). The fiscal note was prepared under provision of section 612 of The Administrative Code of 1929 (71 P. S. § 232).

   The Department estimates the savings of this prior authorization requirement to be approximately $5.163 million per year in total funds.

Contact Person:

   A copy of this notice is available for review at local county assistance offices throughout the Commonwealth.

   Interested persons are invited to submit written comments to this notice within 30 days of this publication. Comments should be sent to the Department of Public Welfare, Office of Medical Assistance Programs, c/o Regulations Coordinator, Room 515, Health and Welfare Building, Harrisburg, PA 17120.

   Persons with a disability may use the AT&T Relay Service by calling 1 [phone] (TDD users) or 1 [phone] (Voice users), or may use the Department of Public Welfare TDD by calling [phone]. Persons who require another alternative format should contact India Wood at [phone].

FEATHER O. HOUSTOUN,   
Secretary

   Fiscal Note: 14-NOT-113. No fiscal impact; (8) recommends adoption. Prior authorization of ulcer drugs is anticipated to save $1,013,000 for fiscal year 1995-96 and $2,431,000 for fiscal year 1996-97 in the Medical Assistance-Outpatient appropriation.

[Pa.B. Doc. No. 96-551. Filed for public inspection April 5, 1996, 9:00 a.m.]