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AWP price decrease for tizanidine tablets hits the WCMSA portal

by
Medicare Insights
| Aug 07, 2019

A new lower price for tizanidine HCL 4 mg tablets is now reflected in the Workers’ Compensation Medicare Set Aside (WCMSA) portal pricing. It was updated August 2, 2019 due to a new lower RED BOOK® Average Wholesale Price (AWP). This reduction in AWP price for a product with many generics currently on the market is unusual, but will provide for significant savings.

Significant reduction in WCMSA costs
Tizanidine is a very common skeletal muscle relaxant used for spasms in workers’ compensation patients. This cost decrease will allow a 94% reduction in WCMSA costs for this medication as compared to the prior lowest AWP noted in the WCMSA portal.

The chart below indicates the pricing reflected in the WCMSA portal as of the August update confirming the price decrease.

Drug name Strength and
formulation
Drug usage Brand AWP New price
Tizanidine 4 mg tablets Skeletal muscle relaxant $1.46/tablet $0.09/tablet

 

OWCA recommendation
It is our recommendation that carriers, TPAs and claim handlers review cases where tizandine has been prescribed to determine the benefit from the decreased cost for the 4 mg tablets. We will proactively reach out to our clients in reference to previously completed WCMSAs where tizanidine was allocated for.

As an established Medicare Secondary Payer (MSP) compliance services provider, one of Optum Workers’ comp goals is to keep clients and the property and casualty insurance industry informed of changes affecting MSP compliance and WCMSAs.

We continually monitor the RED BOOK AWP changes for the most common medications in WCMSAs, as well as generic medications that come to market, and will keep the industry informed.

Sources:
  1. RED BOOK http://www.micromedex.com/products/redbook/awp/
  2. WCMSA portal https://www.cob.cms.hhs.gov/WCMSA/login

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