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What Can You Expect to Pay for Sublocade?

You can expect to pay anywhere from $0 to more than $2,000 per month for Sublocade, depending on your level of insurance coverage.

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Sublocade is a key medication in many people’s fight against opioid use disorder (OUD). Fortunately, there are many ways to make the medication affordable, including private and public insurance coverage, as well as the option to pay out of pocket. 

How Much Does Sublocade Cost?

Sublocade is an effective treatment for OUD, but it comes at a price. Insurance can help to cover much of the cost while paying for it out of pocket can be quite expensive. The chart below outlines the varying costs of Sublocade based on the type of insurance coverage you have.[1]

Type of PaymentCost
Insurance Up to $1,993 per month, depending on your plan
Out of pocketCurrent list price of $2,016 per month
Medicaid$1-$4 per month
Medicare$0-$1,607 per month

Insurance Coverage 

Private insurance companies offer coverage for addiction treatment services, including medications. In fact, the Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008 requires health insurance providers to offer the same amount of coverage for mental health and substance abuse treatment as they do for medical and surgical needs.[3]

Buprenorphine, the active ingredient in Sublocade, is used as a medication-assisted treatment (MAT) option. It is covered by both private and public insurance plans.[3]

Is Sublocade Covered by Medicaid?

Sublocade is generally covered by Medicaid plans, though exact coverage varies by state. A recent review of Medicaid coverage for MAT found that all states offer coverage for some form of medication used in MAT, such as buprenorphine, naltrexone, or methadone. However, less than 70% of states offer reimbursement for extended-release injectable buprenorphine or Sublocade.[4]

If you have Medicaid health insurance and would like to find out if Sublocade is covered under your plan, contact your state-specific plan provider. They will help you figure out if the costs of Sublocade are covered or if you may receive better coverage for a different medication.  

Paying Out of Pocket

Paying out of pocket is the most expensive way to access Sublocade. As of 2019, the monthly cost of a Sublocade injection was approximately $550.[5] The cost of Sublocade has only increased since then, and it is now listed at $2,016 per month.[1]

Paying out of pocket for Sublocade can be unrealistic for many people to afford. Fortunately, low-cost or free treatment options are available as well as grants and scholarships to offset the cost of treatment. Explore the Substance Abuse and Mental Health Service Administration’s (SAMHSA) resources on paying for treatment to learn how to make treatment affordable for you.

Saving Money on the Cost of Sublocade 

One way to save money on the monthly cost of Sublocade is to access the INSUPPORT Copay Assistance program offered by the makers of Sublocade. The program is offered for individuals with private insurance who have been prescribed Sublocade for on-label use, or its intended purposes.[2]

With copay assistance through the INSUPPORT program, it is possible to pay nothing for your first two monthly injections of Sublocade. The program offers payment assistance for up to 14 injections of Sublocade per year. 

It is important to note, that the INSUPPORT Copay Assistance program only helps to cover some of the cost of the Sublocade medication. Additional fees associated with your office visit are not covered.[2]

Requirements for receiving INSUPPORT include the following: 

  • You must be 18 or older.
  • You must live in the United States or a U.S. territory.
  • You must live in a state that accepts copay assistance.
  • You must be enrolled in private health insurance. 
  • Your insurance plan must also cover some of the cost of the Sublocade injection.
  • You must have a valid prescription for Sublocade.

If you meet the above requirements, you may be eligible to receive additional financial coverage for your Sublocade shots, beyond what is covered by your insurance plan. You can visit INSUPPORT.com/savings or call 844-INSPPRT (844-467-7778) to learn more about the program and how to enroll in it.[2]

Payment Options 

Unfortunately, due to the nature of Sublocade and the fact that it must be administered during a medical appointment, there are no affordable prescription options, like GoodRx. It is not available through pharmacies. Rather, it is only distributed to healthcare providers who then administer it to their patients. 

If you have public or private insurance, contact your plan provider to find out how the costs of Sublocade can be covered for you. 

Updated March 18, 2024
Resources
  1. Sublocade pricing. Sublocade.com. Published 2023. Accessed February 23, 2024.
  2. InSupport copay assistance. Indivior UK Limited. Published 2023. Accessed February 23, 2024.
  3. Does insurance cover treatment for opioid addiction? U.S. Department of Health and Human Services. Published December 16, 2022.
  4. Medicaid coverage of medication-assisted treatment for alcohol and opioid use disorders and of medication for the reversal of opioid overdose. Substance Abuse and Mental Health Services Administration. Published 2018. Accessed February 23, 2024.
  5. Pharmacoeconomic review report: Buprenorphine extended-release injection (Sublocade). Canadian Agency for Drugs and Technologies in Health. Published July 2019. Accessed February 22, 2024.
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