Dennis Sponer writes for SRX Advisors:

Pennsylvania – What is AWP? 

AWP pricing in PA is costing the market over $1 million weekly, giving carriers an opportunity to respond. The PA Commonwealth Court, in Federated Insurance v. Bureau of Workers' Compensation, ruled that Red Book AWP is not a reliable basis for setting  workers' compensation medication prices. Stakeholders told the Bureau of Labor and Industry to develop a new standard, yet over two years have passed without action. Meanwhile, WCRI studies reveal WC prescription costs are ten times higher than NADAC, a new benchmark that many payers are moving to. 

For example, a popular antiemetic was billed at $2,596 per claim, whereas the retail price is only $32. Many carriers and TPAs haven't yet realized that Federated's ruling provides a legal basis to challenge AWP-based bills today. You can begin adopting a Federated-based system to review and contest claims immediately, regardless of the Bureau’s future decisions.

Read the full monthly update here.  The WCRI work that they cite is Interstate Variation and Trends in Workers’ Compensation Drug Payments, 5th Edition.  For more on WCRI's work on prescription drug costs, see Workers’ Compensation Prescription Drug Regulations: A National Inventory, 2026 and CompScope™ Medical Benchmarks, 2025.