Provider Briefing: Buprenorphine/Naloxone Supply and Access in 2026

As a provider prescribing Buprenorphine/Naloxone for opioid use disorder (OUD), you know the stakes. Your patients depend on consistent access to this medication — interruptions in treatment can precipitate withdrawal, drive relapse, and in the worst cases, result in fatal overdose. Understanding the current supply landscape is essential to supporting your patients effectively.

This briefing covers the 2026 supply status, prescribing considerations, cost and insurance dynamics, and practical tools to help your patients maintain access.

Timeline: How We Got Here

Buprenorphine/Naloxone has been a cornerstone of medication-assisted treatment for OUD since the FDA approved the Suboxone sublingual tablet in 2002. Key milestones relevant to current availability:

• 2002: Suboxone sublingual tablet approved. Prescribing limited to physicians with a DATA 2000 waiver (X-waiver).
• 2010: Suboxone sublingual film introduced, eventually dominating market share.
• 2013: Generic Buprenorphine/Naloxone sublingual tablets enter the market.
• 2018-2020: Multiple generic film manufacturers gain approval, increasing competition and reducing prices.
• 2023: The X-waiver requirement eliminated by the Consolidated Appropriations Act of 2023, allowing any DEA-registered provider with a Schedule III authority to prescribe Buprenorphine. FDA approves Brixadi (extended-release subcutaneous Buprenorphine injection).
• 2024-2026: Expanded prescribing base, continued generic competition, and sustained telehealth flexibilities. No formal national shortage, but persistent localized access barriers.

Prescribing Implications in 2026

The elimination of the X-waiver was a watershed moment for Buprenorphine access. Any provider with a standard DEA registration and Schedule III prescribing authority can now prescribe Buprenorphine/Naloxone for OUD. Key prescribing considerations:

• No patient cap. The previous 30/100/275 patient limits no longer apply. Providers can treat as many patients as clinically appropriate.
• Training requirement. Providers must complete 8 hours of substance use disorder training (one-time) as part of DEA registration renewal or new registration.
• Telehealth prescribing. Federal flexibilities continue to allow initiation and maintenance of Buprenorphine/Naloxone via telehealth, including audio-only visits in some circumstances. This significantly expands access for patients in rural and underserved areas.
• Formulation options. In addition to sublingual films and tablets, providers can now consider Sublocade (monthly SC injection) and Brixadi (weekly or monthly SC injection) for patients who would benefit from long-acting formulations.

Current Availability Picture

As of early 2026, Buprenorphine/Naloxone is not on the FDA or ASHP drug shortage lists. National supply of generic sublingual tablets and films is generally adequate. However, your patients may still report difficulty filling prescriptions due to:

• DEA aggregate production quotas and pharmacy-level ordering limits that cap how much a pharmacy can dispense monthly
• Pharmacy stocking decisions influenced by corporate policy, perceived liability, or stigma around OUD medications
• Distributor-specific disruptions affecting individual pharmacies, particularly those relying on a single source
• Geographic gaps — rural pharmacies are less likely to stock Buprenorphine/Naloxone, and patients may lack transportation to reach alternatives

These are access barriers, not supply shortages in the traditional sense. But for the patient who can't fill their prescription, the distinction is meaningless.

Cost and Access Considerations

Understanding the cost landscape helps you anticipate patient barriers:

• Generic tablets (8mg/2mg, 30-day supply): $40-$80 with discount card; covered by most Medicaid and commercial plans
• Generic films (8mg/2mg, 30-day supply): $36-$150 with coupon
• Brand Suboxone Film: $155-$570/month without insurance. Indivior offers a copay card saving up to $75/month for commercially insured patients.
• Sublocade injection: ~$1,800-$2,000 per month; generally covered by insurance with prior authorization
• Brixadi injection: Pricing varies; insurance coverage expanding

For patients without insurance, generic tablets represent the most affordable option. Discount platforms like GoodRx and SingleCare can reduce out-of-pocket costs to under $50/month. Patient assistance programs through Indivior (for brand Suboxone), NeedyMeds, and RxAssist are available for qualifying patients.

Direct your patients to our guide on saving money on Buprenorphine/Naloxone for detailed savings strategies.

Tools and Resources for Your Practice

Several resources can help you and your patients navigate availability challenges:

Medfinder for Providers

Medfinder allows providers and patients to check real-time pharmacy stock for Buprenorphine/Naloxone. You can recommend this tool to patients or use it yourself to identify pharmacies that consistently carry the medication in your area.

SAMHSA Treatment Locator

The SAMHSA treatment locator (findtreatment.gov) helps patients find OUD treatment providers and programs, including those offering Buprenorphine, Methadone, and Naltrexone.

Pharmacy Relationships

Building relationships with 2-3 pharmacies that reliably stock Buprenorphine/Naloxone is one of the most effective strategies. Independent pharmacies often have more flexibility and willingness to serve OUD patients than large chains. Consider maintaining a list of trusted pharmacies to share with patients.

Formulation Flexibility

When a specific formulation is unavailable, consider switching between:

• Sublingual film ↔ sublingual tablet (generic)
• Suboxone ↔ Zubsolv (note: not mg-for-mg equivalent due to bioavailability differences)
• Daily sublingual ↔ extended-release injection (Sublocade, Brixadi) for stable patients

Looking Ahead

Several trends are likely to shape Buprenorphine/Naloxone access in the coming years:

• Continued generic price competition should keep costs manageable for most patients
• Growth of long-acting injectable formulations (Sublocade, Brixadi) may reduce dependence on pharmacy-dispensed sublingual products
• Telehealth normalization will continue expanding the prescriber base and patient reach
• DEA quota reform efforts may eventually address pharmacy-level ordering limitations, though progress has been slow
• Stigma reduction in the pharmacy setting remains an ongoing challenge requiring advocacy at both the corporate and individual level

Final Thoughts

Buprenorphine/Naloxone remains the most widely prescribed medication for opioid use disorder, and for good reason — it's effective, relatively safe, and increasingly accessible. The barriers your patients face are real but navigable with the right tools and proactive planning.

Equip your patients with resources like Medfinder, maintain pharmacy relationships, and stay flexible with formulation options. For a patient-facing perspective you can share, see our Buprenorphine/Naloxone shortage update for patients.

For guidance on helping patients manage costs, see our provider's guide to helping patients save money on Buprenorphine/Naloxone.