The National Alliance of Advocates for Buprenorphine Treatment
Subutex®3, Zubsolv®4, Bunavail™5, Probuphine®6) is an opioid
medication used to treat opioid addiction in the privacy of a physician's office.1
Buprenorphine can be dispensed for take-home use, by prescription.1 This, in
addition to the pharmacological and safety profile of buprenorphine, makes it an attractive
treatment for patients addicted to opioids.2
FDA approved generic equivalents for Suboxone®(Bup/Nx) sublingual tablets
- (not the film) - in 2mg and 8mg sizes. In October 2009 generic
Subutex® (Bup) sublingual tablets in 2mg and 8mg sizes were approved. Prices for generics have not yet dropped significantly below brand-name products, and in some cases may even be more expensive, check with your pharmacy.
Pharmaceutical Manufacturer's Copay cards
– Patients can get discounts (see websites for details and restrictions) of out-of-pocket brand-name product costs. The copay cards can be printed from the manufacturer's websites and presented to the pharmacist. They can be used to cover all or part of the insurance copay or to save cash-paying patients. (patients using; Medicaid, Medicare, Medigap, VA, DOD, or TriCare - are NOT eligible for discounts)
Bunavail™ (Bup/Nx)buccal film - This card can be used to save insured patients up to $100/month off out-of-pocket costs, while cash-paying patients can save up to $270/month (see details and conditions). Sub-Bunavail Dose Conversion Calculator
For eligible patients using insurance - this card covers up to $75 each month on your copay. Limit 1 fill per month. For eligible new patients using insurance, this card allows for 2 fills the first month for a total copay savings of up to $75 off. Patients who have used a savings card for SUBOXONE Film in the past 12 months are not eligible for the additional new patient offer.
For eligible patients not using insurance - this card covers up to $0.96 off per individual 2 mg Film (up to 90 Films or $86 per month), $1.92 off per individual 4 mg and 8 mg Film (up to 90 Films or $173 per month), and up to $3.84 off per individual 12 mg Film (up to 60 Films or $230 per month). Multiple fills are allowed each month up to maximums listed.
Zubsolv® (Bup/Nx)tablet - This card provides a $2.50 discount off each tablet toward out-of-pocket costs, up to $225/use and can be used multiple times per month. Example; a cash paying patient who requires 60 tablets/month would receive $150 discount per month. Anonymously print out a card from the website. Sub-to-Zub Dose Converter Calculator
Pharmaceutical Manufacturer's FREE meds program
–Some manufacturers of buprenorphine products have launched patient assistance programs (PAP) to help low income patients afford their medication. Some patients qualify for FREE medication for up to a year. Each program have their own procedures, qualification criteria, restrictions and rules. Click to find details about the Suboxone Film PAP and the Zubsolv PAP.
Marketing and academic research opportunities
– Occasionally, research firms want to survey patients in buprenorphine treatment and often offer some sort of honorarium, usually
$25-$100 depending on the length of the survey
. These are typically anonymous and take 5-20 minutes to complete. naabt.org and AddictionSurvivors.org will post listings of opportunities once they become available and are verified as legitimate.
Buy your own drug test kits online
– Most physicians conduct
urine tests for illicit drugs
at each office visit.
Often, the urine is sent to a lab for processing, this can be expensive. If the physician is willing, the patient can
purchase drug test kits online for under $10. This could save hundreds depending on how often and how many drugs are tested for.
Third-party prescription discount cards
– There are a number of discount cards available from sources
like AAA, some pharmacy chains and discount prescription websites. The AddictionSurvivors.org discussion board has an area dedicated to
discussing these cards and gives the opportunity to hear from people who actually used them.
– If patients can't afford the entire prescription all at once, they can ask the pharmacy to dispense a partial prescription. This type of partial dispensing should not count as a refill. Although this doesn't actually save any money, it may be a way to afford to stay in treatment when there isn't enough money to purchase the entire prescription.
– Can be a source of both
free medical care
, although the patient will be subject to whatever conditions are set up in the study.
Look for open label Phase IV studies
which means the medication is already FDA approved and you will know what medication is being provided. www.clinicaltrials.gov
Negotiate with the provider
– Patients may be able to
negotiate a lower price
with their physician or counselor, particularly if you have been a long-term stable patient.
Less frequent office visits
– As the patient stabilizes, s/he can request to have less frequent office visits. Although physicians commonly require patients to come in for appointments every month to monitor the patient's progress,
schedule III medications can be refilled up to 5 times in a 6 month period
. Visit frequency is ultimately determined by the physician, but it doesn't hurt to ask, particularly for those
stable in long-term addiction remission
and those who get therapy or counseling from other sources. Some states however, overrule the physician's judgment and have set minimum periods between office visits.
Lower buprenorphine dose
– If the patient has been stable for several months, s/he may find that a
lower dose still suppresses cravings and withdrawal symptoms
. Discuss this with the physician, of course, to make sure that no more medication is being taken, and paid for, than is needed to maintain addiction remission. Also,
doses above the patient's ceiling dose provide little, if any, additional benefit
. The correct dose is the lowest dose which still suppresses cravings and withdrawal.
Physician Referral fee
– Some physicians will provide a referral fee or discount when patients are directly referred to treatment.
Methadone Clinics (OTPs)
– Some methadone clinics(OTPs) also offer buprenorphine. This varies state to state and clinic to clinic but it
may be subsidized in some way
and available at reduced cost. However, find out the rules and dispensing criteria for each clinic beforehand, which
often initially consists of daily witnessed dosing at the clinic
– Shopping around for a good value is
not what is meant by the term "doctor shopping"
which refers to seeing several doctors for the same ailment without the other doctor's knowledge. The intention of "doctor shopping" is to obtain multiple prescriptions, often opioid pain relievers, from multiple doctors.
Shopping around for a good value is prudent
so long as it doesn't delay the commencement of life-saving treatment. One strategy is to
begin treatment immediately then search for better value
To suppress the debilitating symptoms of cravings and withdrawal, enabling the patient to engage in therapy,
counseling and support, so they can implement positive long-term changes in their lives which develops into the new healthy patterns of behavior necessary to achieve sustained addiction remission. - explain -
The National Alliance of Advocates for Buprenorphine Treatment is a non-profit organization charged with the mission to:
Educate the public about the disease of opioid addiction and the buprenorphine treatment option.
Help reduce the stigma and discrimination associated with patients with addiction disorders.
Serve as a conduit connecting patients in need of treatment to buprenorphine treatment providers.
Center for Substance Abuse Treatment. Clinical Guidelines for the Use of Buprenorphine in the Treatment of Opioid Addiction. Treatment Improvement Protocol (TIP)
Series 40. DHHS Publication No. (SMA) 04-3939. Rockville, Md: Substance Abuse and Mental Health Services Administration, 2004.