- The cost of any drug is determined by several factors: the set costs of the pharmaceutical manufacturer, the classification of the drug by a health plan or prescribing clinic and dispensing pharmacies that sell the drug at retail. In the case of Suboxone, which must be dispensed by a certified physician, a patient has to also take into consideration the cost of office visits, lab tests,or any emergency stabilization that must take place.
- The daily dose of Suboxone also sets the cost to the patient. Common daily doses range between 8mg to 24mg, and the higher doses generally have a higher retail cost, although this varies geographically.
- Suboxone is classified by many health insurance drug plans as a niche medication, because it is FDA-approved only to treat opioid dependence. It is often considered off-formulary, which translates into higher co-pays for patients.
- As the demand rises, many private insurance companies are increasing their coverage of office visits related to Suboxone treatment, and many are covering great percentages of the medication cost. For example, the number of prescribed pills affects the co-pays required by federal Blue Cross/Blue Shield.
- Medicaid coverage for Suboxone varies from state to state. Some states may cover office visits but not the medication, or vice-versa. Coverage usually depends on a few factors: authorization, the determination of "medical necessity" and whether Suboxone is on the state's formulary list.
- There are private assistance programs available to help offset the costs of Suboxone treatment. For example, Reckitt Benckiser Pharmaceuticals, the company that manufactures Suboxone, has a Patient Assistance Program that offers free or low-cost Suboxone to patients who are otherwise unable to afford it. Patients must qualify by meeting certain financial guidelines, and can usually begin the process by contacting the pharmaceutical company for more information.
Considerations
Doses
Niche
Coverage
Medicaid
Assistance
SHARE
