Cost Is One of the Biggest Barriers to Buprenorphine Adherence

You know Buprenorphine works. The evidence is overwhelming: it reduces overdose deaths, improves treatment retention, and helps patients stabilize their lives. But none of that matters if your patients can't afford to fill their prescriptions.

Cost-related non-adherence is a persistent problem in opioid use disorder treatment. Patients who struggle to pay for Buprenorphine are more likely to miss doses, skip refills, or abandon treatment entirely — with potentially fatal consequences. As a prescriber, you're in a unique position to connect patients with savings programs and cost-reduction strategies that can keep them on track.

This guide covers what your patients are paying, the programs available to reduce those costs, and how to build cost conversations into your clinical workflow.

What Patients Are Actually Paying for Buprenorphine

Buprenorphine costs vary dramatically depending on formulation, insurance status, and pharmacy:

• Generic Buprenorphine/Naloxone sublingual tablets: $45-$130/month with discount coupons; $150-$300/month at retail without insurance
• Brand Suboxone film: $400-$600/month
• Butrans transdermal patch: $200-$500/month
• Belbuca buccal film: $300-$500/month
• Sublocade monthly injection: $1,500-$1,900/month
• Brixadi injection: Similar range to Sublocade

Even with insurance, copays for brand-name Buprenorphine products can run $50-$150/month — a significant burden for patients who may be rebuilding financially during recovery. Prior authorization requirements and step therapy mandates add further barriers.

For uninsured patients, the cost of generic sublingual Buprenorphine with a discount coupon ($45-$130/month) is manageable for some but prohibitive for others, particularly when combined with the cost of office visits and drug testing.

Manufacturer Savings Programs

Several manufacturers offer copay assistance and patient support programs:

Indivior — INSUPPORT Program

Covers Suboxone and Sublocade. The INSUPPORT program provides:

• Copay assistance for commercially insured patients — may reduce copay to as low as $5/month
• Patient assistance program (PAP) for uninsured or underinsured patients who meet income criteria
• Nurse support and treatment coordination

Providers can help patients enroll at insupport.com or by calling the INSUPPORT line.

Braeburn — Brixadi Savings

Braeburn offers savings programs for Brixadi, their extended-release injection. Copay cards are available for commercially insured patients. Because Brixadi is administered in-office, the Buy & Bill process means your practice may be able to facilitate cost savings directly.

Collegium — Belbuca Savings

Collegium offers copay assistance for Belbuca (buccal film for chronic pain). Eligible commercially insured patients can pay as little as $0 per prescription.

What to Know About Manufacturer Programs

• Most programs are for commercially insured patients only — federal healthcare beneficiaries (Medicare, Medicaid, TRICARE) are typically excluded due to the Anti-Kickback Statute
• Enrollment is usually simple: online form or phone call
• Programs may have annual caps on savings
• Renewal is typically required annually

Coupon and Discount Cards

For patients paying cash or facing high copays, discount card programs can dramatically reduce costs:

• GoodRx — Shows prices at nearby pharmacies with coupons. Generic Buprenorphine/Naloxone sublingual tablets can be as low as $45/month.
• SingleCare — Free discount card accepted at most major pharmacies
• RxSaver — Price comparison tool with printable coupons
• Optum Perks — Discount cards for generic and brand medications
• BuzzRx — Free savings card with no signup required

These programs work especially well for generic formulations. For brand-name products, manufacturer copay cards typically offer better savings.

Tip: Encourage patients to compare prices across pharmacies. The same generic Buprenorphine prescription can vary by $50-$100+ between pharmacies in the same ZIP code. Independent pharmacies often offer competitive pricing.

Patient Assistance Programs for the Uninsured

For patients without insurance or with inadequate coverage:

• SAMHSA National Helpline (1-800-662-4357) — Free referrals to local treatment programs, many of which provide Buprenorphine at no cost
• NeedyMeds (needymeds.org) — Database of patient assistance programs searchable by medication
• RxAssist (rxassist.org) — Comprehensive directory of pharmaceutical assistance programs
• RxHope (rxhope.com) — Connects patients with manufacturer PAPs
• State Medicaid programs — Many states mandate coverage for all FDA-approved OUD medications with $0 copay. Help uninsured patients explore Medicaid eligibility.
• Federally Qualified Health Centers (FQHCs) — Offer sliding-scale fees based on income and often provide Buprenorphine treatment

Generic Alternatives and Therapeutic Substitution

Prescribing generics is the single most impactful cost-reduction strategy for most patients:

Generic Buprenorphine/Naloxone

Generic sublingual films and tablets are widely available and therapeutically equivalent to brand-name Suboxone. At $45-$130/month with coupons versus $400-$600/month for brand Suboxone, the savings are substantial.

Unless there's a clinical reason for the brand (e.g., specific formulation tolerability), generic should be the default. Write prescriptions allowing generic substitution.

Formulation Switching

If a patient is struggling with the cost of one formulation, consider whether a different delivery method might be more affordable or better covered:

• Sublingual tablets are generally the cheapest option
• Long-acting injectables (Sublocade, Brixadi) may be more cost-effective through medical benefit (not pharmacy benefit) coverage — particularly for insured patients where the injection is billed as a medical procedure
• Some patients may have better formulary coverage for Zubsolv than generic Buprenorphine/Naloxone, or vice versa

Prior Authorization Support

When insurance requires prior authorization, proactive support from your practice can prevent treatment gaps:

• Submit PAs promptly with clinical documentation
• Use electronic PA when available to speed processing
• Have a staff member designated to manage PA workflows
• Provide bridge prescriptions when PA is pending

Building Cost Conversations into Your Workflow

Many patients won't volunteer that they're struggling with medication costs. Build these conversations into routine care:

At Initial Prescribing

• Ask about insurance status and pharmacy benefit coverage
• Prescribe generic Buprenorphine/Naloxone unless there's a clinical reason not to
• Provide information about discount cards (keep GoodRx printouts or QR codes in the office)
• Connect uninsured patients with your practice's social worker or care coordinator for assistance program enrollment

At Follow-Up Visits

• Ask: "Are you having any trouble affording your medication?"
• Monitor refill patterns — missed refills may indicate cost barriers, not non-compliance
• Reassess insurance status annually (patients may gain or lose coverage)
• Update discount card recommendations as prices change

In Your Practice

• Post information about savings programs in your waiting area
• Train front desk and nursing staff on basic cost-assistance resources
• Keep a reference sheet of current discount programs (this post can serve as a starting point)
• Consider partnering with a pharmacy that offers competitive pricing and reliable Buprenorphine stocking

For help directing patients to pharmacies that actually stock Buprenorphine, recommend Medfinder for providers. You can also read our clinical guide on helping patients find Buprenorphine in stock.

Final Thoughts

Cost should never be the reason a patient stops Buprenorphine treatment. As prescribers, we can't control drug prices, but we can control how proactively we address cost barriers. Prescribing generics, connecting patients with savings programs, and normalizing cost conversations are simple steps that improve adherence and save lives.

The resources are out there. Your patients just need help finding them — and often, that help starts with you.

For more on Buprenorphine access challenges affecting your patients, see our provider guides on the Buprenorphine shortage and helping patients find Buprenorphine in stock.