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) for FDA-approved to treat opioid use disorder (opioid addiction). Medication-assisted treatment with either buprenorphine or methadone is widely recognized in the medical community as the gold standard of treatment for opioid addiction.
Suboxone (buprenorphine/naloxone) helps to alleviate the brain’s dependence on opioids like heroin, fentanyl, and prescription pain pills, reduces cravings, and mitigates withdrawal symptoms.
Suboxone (buprenorphine/naloxone) is a partial opioid agonist, which means it binds to opioid receptors in the brain and partially fills them. It has what is called a “ceiling effect,” so for most people it does not provide the “high” associated with opioids like heroin. Suboxone also contains naloxone (known by the brand name Narcan), an opioid antagonist that fully blocks opioid receptors. When taken as directed, the naloxone is not well absorbed and has no noticeable impact, 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 less likely to be diverted or misused than many other opioid medications.
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, many 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 available at a lower price than strips. For example, the lowest price for 14 tablets of this medication can fall around $25. By contrast, 14 Suboxone films can cost $40 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 table is a little less when you get them in higher quantities, even though price you’re paying at the pharmacy is higher all together. On a recent search we found that the price per strip price was often $.50 less 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 in small packages.
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 prescribtion, 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 off to compare prices with pharmacies in your area before you tell your doctor where to send the prescription! Big-box stores like Costco are often 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 $177-$570 for a 30-day supply. Generic buprenorphine-naloxone costs a lower price of $60-$300 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 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.
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