Table 4. Final recommendation.

Recommendation 1: Reimbursement at 100% of Medi-Cal and for drugs are not covered by a Medi-Cal, calculate the maximum fee as 60% of AWP. For drugs that are not covered by either Medi-Cal or AWP, calculate the maximum fee as 97% of WAC
100% of Medi-Cal	97.30%	$109,657,753	$111,627,060	$1,969,307
60% of AWP	96.70%	$5,325,626	$10,611,632	$5,286,006
97% of WAC	0%	$0	$0	$0
Drugs that are not covered by the previous pricing benchmarks	0.1%	$151,983	$0	$151,983
Total	99.9%	$115,135,363	$122,238,692	$7,255,313
Recommendation 2: Reimbursement at 100% of and for drugs are not covered by NADAC, calculate the maximum fee as 60% of AWP. For drugs that are not covered by either Medi-Cal or AWP, calculate the maximum fee as 97% of WAC
100% of NADAC	94.20%	$101,092,760	$76,869,650	-$24,223,110
60% of AWP	88.30%	$12,259,281	$17,625,668	$5,366,387
97% of WAC	12.30%	$113,513	$117,532	$4,019
Drugs that are not covered by the previous pricing benchmarks	0.6%	$1,669,807	$0	$1,669,807
Total	99.4%	$115,135,363	$94,612,850	-$17,182,897
Recommendation 3: lower of Medi-Cal or NADAC. Then for those drugs not covered by either Medi-Cal or NADAC, calculate the maximum fee as 60% of AWP
lower of Medi-Cal or NADAC 93.6%		$100,196,486	$75,739,896	-$24,456,486
60% of AWP 89.5%		$13,155,473	$18,243,674	$5,088,201
Drugs that are not covered by the previous pricing benchmarks	1%	$1,783,408	$0	$1,783,408
Total	99%	$115,135,363	$93,983,570	-$17,584,877

Note: CAWCS, California Workers’ Compensation System; AWP, Average Wholesale Price; WAC, Wholesale Acquisition Cost; NADAC, National Average Drug Acquisition Cost.

This table examines the implications of each recommendation and calculates the cost-saving compared to the current CAWCS pricing scheme over three years.