Your Patients Can't Find Buprenorphine. Here's How to Help.

You wrote the prescription. Your patient is ready to start — or continue — treatment for opioid use disorder. Then they call your office: "The pharmacy doesn't carry it." Or worse, they simply don't fill it and drop out of care.

This scenario plays out every day in clinics across the country. As we detailed in our provider briefing on Buprenorphine availability, about 40% of major chain pharmacies don't stock Buprenorphine, and rural patients face even steeper barriers.

This guide offers concrete steps you and your staff can take to help patients find Buprenorphine and stay in treatment.

Current Availability: What You Need to Know

Buprenorphine is not in formal FDA shortage. The manufacturing supply chain is intact. The bottleneck is at the pharmacy counter:

• ~40% of Walmart, CVS, and Rite Aid locations decline to stock Buprenorphine
• Independent pharmacies are significantly more likely to carry it
• Rural areas have the worst access due to fewer pharmacies overall
• Even pharmacies that stock it may experience intermittent stockouts between deliveries

Why Patients Can't Find It

Understanding the root causes helps you anticipate and address patient barriers:

1. Pharmacy refusal to stock: Many chains avoid Buprenorphine due to DEA scrutiny, diversion concerns, and OUD stigma
2. Geographic barriers: Rural patients may have only 1-2 pharmacies within driving distance, neither of which stocks Buprenorphine
3. Insurance and cost: Prior authorization delays can add days. Cash prices for brand Suboxone ($400-$600/month) are prohibitive for uninsured patients
4. Patient stigma: Some patients are reluctant to call multiple pharmacies or feel judged when asking about Buprenorphine
5. Timing: Pharmacies may run out mid-week between deliveries, creating short-term gaps

What Providers Can Do: 5 Steps

Step 1: Build a Pharmacy Network

Identify 3-5 pharmacies in your area that reliably stock Buprenorphine. Prioritize independent pharmacies and those affiliated with addiction treatment centers. Maintain a list that your front desk staff can reference when patients need a pharmacy recommendation.

Use Medfinder for Providers to identify pharmacies with current stock. This can be integrated into your prescribing workflow so patients leave your office with a specific pharmacy to visit.

Step 2: Send Prescriptions to Known-Good Pharmacies

Instead of e-prescribing to the patient's default pharmacy (which may not stock Buprenorphine), direct the prescription to a pharmacy you've confirmed carries it. This simple change can prevent the majority of failed fill attempts.

If the patient prefers a specific pharmacy, call ahead to verify stock before sending the prescription.

Step 3: Proactively Address Prior Authorization

Many insurance plans require prior authorization for Buprenorphine, especially brand-name products. To minimize treatment delays:

• Submit prior auth requests at the time of prescribing, not after a pharmacy rejection
• Use generic Buprenorphine/Naloxone sublingual film or tablets as first-line (most likely to be covered without PA)
• Keep prior auth forms for major payers on file for quick submission
• Consider prescribing a bridge supply while PA is pending

Step 4: Offer Long-Acting Injectable Formulations

For patients with chronic pharmacy access problems, transitioning to Sublocade (monthly injection) or Brixadi (weekly or monthly injection) eliminates the pharmacy barrier entirely. These are administered in your office and covered by most insurance plans.

Benefits for your practice:

• Improved treatment retention (no missed doses)
• Reduced diversion risk
• Steady-state blood levels
• Monthly touchpoints with patients

Both products have buy-and-bill models and manufacturer support for reimbursement navigation.

Step 5: Connect Patients With Cost-Saving Resources

Cost is the second most common barrier after availability. Equip your patients — or your staff — with these resources:

• GoodRx / SingleCare: Generic sublingual Buprenorphine as low as $45/month
• Indivior INSUPPORT: Copay assistance for Suboxone and Sublocade
• Braeburn savings: Brixadi manufacturer savings program
• SAMHSA helpline: 1-800-662-4357 for free treatment and financial assistance referrals
• NeedyMeds / RxAssist: Patient assistance program directories
• State Medicaid: Many states cover OUD medications with no copay

For a comprehensive cost guide to share with patients, see: How to Save Money on Buprenorphine.

Alternatives to Consider

When Buprenorphine truly isn't accessible for a patient, evidence-based alternatives include:

• Methadone: Full agonist, available through certified OTPs. Best for patients with severe OUD or those who've not responded to Buprenorphine. Requires daily clinic visits initially.
• Naltrexone (Vivitrol): Monthly injection opioid antagonist. Requires full detox. Good for highly motivated patients. No abuse potential.

See our patient-facing alternatives guide for detailed comparisons.

Workflow Tips

Integrate pharmacy access into your standard OUD treatment workflow:

1. At initial visit: Identify a pharmacy that stocks Buprenorphine using Medfinder. Send the prescription directly there.
2. At each follow-up: Ask if the patient had any trouble filling their prescription. If yes, help them identify a new pharmacy.
3. Designate a staff member (MA, care coordinator, social worker) as your pharmacy liaison. They handle stock checks, PA submissions, and patient assistance applications.
4. Create a handout with your recommended pharmacies, cost-saving resources, and the Medfinder link. Give it to every patient receiving Buprenorphine.
5. Track pharmacy fill rates in your EHR to identify patterns and proactively address access barriers.

Final Thoughts

The Buprenorphine prescribing landscape has never been more open. The remaining barrier — pharmacy access — is one that providers can directly influence through smart workflows, pharmacy relationships, and patient education.

By taking these five steps, you can significantly reduce treatment dropouts caused by pharmacy access issues. Visit medfinder.com/providers to start checking pharmacy stock for your patients today.