Suboxone treatment without insurance
The basics of what impacts the cost of Suboxone (buprenorphine/naloxone) and how to afford it without insurance.
What is Suboxone and how is it used to treat opioid use disorder?
Suboxone is the brand name of a medication (buprenorphine/naloxone) approved by the FDA to treat opioid use disorder (some say opioid addiction). Medication for addiction treatment (MAT) is the use of medicine to treat substance use disorder. MAT with either buprenorphine or methadone is considered the gold standard of treatment for opioid addiction.
Suboxone (buprenorphine/naloxone) helps support recovery from opioids like heroin, fentanyl, and prescription pain pills. It relieves cravings and reduces or stops withdrawal symptoms.
How does Suboxone work?
Buprenorphine is a partial opioid agonist. It binds to opioid receptors in the brain and partially activates them. The partial activation lets it relieve withdrawals and cravings without the “high” or euphoria common with full opioid agonists. It has what is called a “ceiling effect,” in which its effect reach a plateau. Past a certain point, taking more won’t cause increased effects.
Suboxone also contains naloxone (known by the brand name Narcan), an opioid antagonist that fully blocks opioid receptors. If you take Suboxone as directed, the naloxone doesn’t do anything. But when Suboxone (buprenorphine/naloxone) is misused, the naloxone prevents a high. Because of buprenorphine’s ceiling effect and the presence of naloxone, Suboxone is considered less likely to be misused than many other opioid medications.
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Under the Affordable Care Act, addiction treatment is mandated to be covered by most health insurance plans. But what about people who don’t have insurance, or whose insurance doesn’t cover prescriptions?
What determines the cost of Suboxone (buprenorphine/naloxone)?
Without insurance, medications can put a big dent in your pocketbook, and Suboxone is no different. There are a few factors that help to determine how much your Suboxone prescription will cost:
Whether the prescription calls for strips or tablets
When your doctor writes the prescription, they determine how it can be dispensed. Generic buprenorphine/naloxone (Suboxone, Bunavail, and Zubsolv are name-brand versions) is available as either a tablet or a sublingual film. Both options need to be dissolved in the mouth, either under the tongue or against the cheek. For most people, both options produce similar results, but some find that one version works better for them than the other.
Often, the tablets are a little less expensive than strips. For example, the lowest price we could find near us for 14 tablets of this medication is around $25. By contrast, 14 Suboxone films can cost $36 at their lowest price.
The number of pills or strips in the prescription
The cost of buprenorphine/naloxone often depends on the number of pills or strips stated in the prescription, starting at 14. Often, the price per strip or tablet is a little less when you get them in higher quantities, even though amount you’re paying at the pharmacy is higher all at once.
On a recent search we found that the price for strips was often $.50 less per strip when they were purchased in 60-count packages than in 14-count packages. It’s similar to the way toilet paper or yogurts cost less in bulk than they do when you buy a single or small package.
Keep in mind that your doctor cannot prescribe you extra tablets or strips just to help you save money, because buprenorphine is a controlled substance.
The medication strength
Buprenorphine/naloxone is generally available in four strengths:
- 2 mg buprenorphine/ 0.5 mg naloxone
- 4 mg buprenorphine/ 1 mg naloxone
- 8 mg buprenorphine/ 2 mg naloxone
- 12 mg buprenorphine/ 3 mg naloxone
The cost varies with the strength of the prescription, but it isn’t a one-to-one correlation. In some areas and pharmacies, 8mg may be cheaper than 4mg. If your doctor wants you to take 4mg twice a day, it may be more cost-effective to ask for an 8mg prescription that you can split in half.
Where you get your prescription filled
Even in the same city, medication prices vary dramatically depending on what pharmacy fills them. In a search of one area, we found that it cost 3.5 times more to fill a prescription for generic Suboxone at one grocery store pharmacy than at its cheapest competitor. It pays to compare prices with pharmacies in your area before you tell your doctor where to send the prescription!
Big-box stores like Costco may be the most cost-effective option and usually do not require you to have a membership in order to get your prescriptions filled there.
Cost of Suboxone (buprenorphine/naloxone) without insurance
At the time of this writing, name-brand Suboxone prices can range anywhere from $350-$1,200 for a 30-day supply, depending on your dosage and where you fill the prescription. Generic buprenorphine-naloxone costs a lower price of $120-$500 for a one-month supply, depending on the factors described above.
Ways to reduce the cost of Suboxone (buprenorphine/naloxone):
If you don’t have insurance, or if it won’t cover your Suboxone, there are some ways to reduce your out-of-pocket payments. These include:
Prescription savings cards
Prescription discount cards are issued by companies that partner with pharmacies and drug manufacturers to reduce costs for self-pay medication. These cards are available for free over the internet, and many of them have apps.
When you have a prescription savings card, you present it at a participating pharmacy and get your meds at a discounted rate. Some popular programs (with which we are not affiliated) include GoodRX, WellRX, SingleCare, and Optum Perks.
Patient assistance programs
The companies that manufacture medications often offer programs to assist people who need them but can’t afford them. Through these patient assistance programs, patients managing opioid use disorder may be able to get a year’s supply of the medication at no cost (dispensed one month at a time. To qualify, you will need to have a clinical, FDA-approved diagnosis of opioid use disorder and to have no insurance coverage. This assistance is usually reserved for those below a certain income level. You can search for patient assistance programs for your medication to see if you qualify.
Partial prescription dispensing
Sometimes even if the price can’t be lowered, a pharmacy can spread out the cost through partial dispensing. When this happens, the pharmacist dispenses less than the prescribed quantity of the medication, so you don’t have to pay for the full prescription all at once. Talk to your pharmacist to see if this is an option.
Manufacturer coupons
Manufacturer coupons come from the pharmaceutical companies themselves, and help you save on the cost of a predetermined number of prescription refills. There are some caveats. Manufacturer coupons generally can’t be used with state-provided insurance like Medicaid, Medicare, or TriCare (the insurance that covers members of the military). To be eligible for these coupons, you may be required to provide your personal or medical information to the pharmaceutical company. Understandably, these coupons are only available on the medication the manufacturer makes, so to use a coupon provided by Indivior, you would have to get name brand Suboxone, not a generic version. (Zubsolv’s manufacturer Orexo also offers manufacturer coupons.) Manufacturer coupons are restricted to specific limits on time or number or refills. After a few months or a year, these coupons will run out.
What are the risks and concerns about Suboxone?
Suboxone (buprenorphine/naloxone) is indicated for the treatment of opioid dependence in adults. Suboxone should not be taken by individuals who have been shown to be hypersensitive to buprenorphine or naloxone as serious adverse reactions, including anaphylactic shock, have been reported. Taking Suboxone (buprenorphine/naloxone) with other opioid medicines, benzodiazepines, alcohol, or other central nervous system depressants can cause breathing problems that can lead to coma and death. Other side effects may include headaches, nausea, vomiting, constipation, insomnia, pain, increased sweating, sleepiness, dizziness, coordination problems, physical dependence or abuse, and liver problems. For more information about Suboxone (buprenorphine/naloxone) see Suboxone.com, the full Prescribing Information, and Medication Guide, or talk to your healthcare provider. You are encouraged to report negative side effects of drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.
How to get started
Download the app
Download the Workit Health app, answer a few questions, and schedule your first appointment.
First appointment
Meet your dedicated licensed clinician in a 1:1 video call and discuss your recovery goals, care plan, and any necessary medication.
Pick up your medications
As appropriate, your clinician will e-prescribe medication to your pharmacy to relieve cravings and support your recovery.
Monthly group follow-ups
Connect with your provider, a coach, and other members on the same journey in shared follow-up visits each month.
Citations
1. Buprenorphine. Substance Abuse and Mental Health Services Administration (SAMHSA). https://www.samhsa.gov/medication-assisted-treatment/medications-counseling-related-conditions/buprenorphine. Accessed November 2021.
2. Fiellin, D. A., Moore, B. A., Sullivan, L. E., Becker, W. C., Pantalon, M. C., Chawarski, M. C., Barry, D. T., O’Connor, P. G., & Schottenfeld, R. S. (2008) Long-Term Treatment with Buprenorphine/Naloxone in Primary Care: Results at 2–5 Years, American Journal on Addictions, 17:2, 116-120, https://doi.org/10.1080/10550490701860971
3. Abraham, A. J., Andrews, C. M., Grogan, C. M., D’Aunno, T., Humphreys, K. N., Pollack, H. A., & Friedmann, P. D. (2017). The Affordable Care Act Transformation of Substance Use Disorder Treatment. American journal of public health, 107(1), 31–32. https://doi.org/10.2105/AJPH.2016.303558
4. Munigala, S., Brandon, M., Goff, Z. D., Sagall, R., & Hauptman, P. J. (2019). Drug discount cards in an era of higher prescription drug prices: A retrospective population-based study, Journal of the American Pharmacists Association, 59 (6), 804-808. https://doi.org/10.1016/j.japh.2019.05.021.
5. Patient Information for Suboxone ™ (buprenorphine and naloxone). Suboxone. https://www.suboxone.com/. Accessed June 30, 2022.