Another Average Wholesale Price Change


By Dr. Nahla D. Rizkallah, Senior Clinical Pharmacist

Another average wholesale price (AWP) has changed. As part of best practices, ExamWorks Clinical Solutions continually monitors the Center for Medicare and Medicaid Services (CMS’s) recognized proprietary source, Red Book, for real-time changes to AWP for medications used to treat the injured worker. It is noted that pricing of morphine sulfate products have been reduced considerably:

o   15mg extended–release (ER) tablet was $1.05 and is now $0.38

o   30mg ER tablet was $1.50 and is now $0.73

o   60mg ER tablet was $3.39 and is now $1.40

o   100mg ER tablet was $4.20 and is now $2.11

o   Some immediate-release tablets have increased by approximately 18%

Such changes can significantly reduce the Workers Compensation Medicare Set-Aside Arrangement (WCMSA) and facilitate settlement.

ExamWorks Clinical Solutions strives to provide the most accurate and defensible MSA by utilizing technology and compendia databases which are recognized and supported by the CMS to support inclusion or exclusion of a drug under the Part D benefit. We will continue to monitor changes in medication pricing as well as availability of generic equivalents within the marketplace. 

For questions about medications, please contact Nahla D. Rizkallah, PharmD at 678-256-5086 or

About Nahla Rizkallah

Nahla D. Rizkallah, PharmD, MSCC, is Senior Clinical Pharmacist at ExamWorks Clinical Solutions (ECS). In this capacity, she performs quality assurance on pharmacy reports, prescription analysis to optimize drug therapy using evidence-based guidelines and national guidelines and participates in physician outreaches to implement the recommendations. She has 29 years of experience in various area of pharmacy practice including review of Part D medications on Medicare Set-Aside Allocations, Pharmacy and Therapeutics Committee, Pharmacy Manager for a closed mental health facility, Pharmacy Manager for the indigent, staff/clinical pharmacist for assisted-living facilities (ALFs), medication audits for ALFs, drug information center, clinical pathways, staff education, and surgical/medical pharmacy satellite at All Children’s Hospital. Dr. Rizkallah received her Doctorate from the University of Florida in Gainesville followed by a one-year American Society of Health-System Pharmacists accredited residency.