COSTS OF MEDICATIONS FOR ADDICTION, SUBSTANCE ABUSE, AND OPIOID MAINTENANCE

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Largely dependent on the insurance coverage, medications available at pharmacies may be estimated on the basis of www.goodrx.com data (cash pay price).  Some insurances cover most or all of the medication costs.  The cost of treatment includes medications, physician visits, external counseling, urine drug screens, drug confirmation testing, and lab testing for liver function testing and pregnancy.  Some clinics separate each of these out and charge individually while others roll all these into a single fee, typically $21 per day of therapy or $630 per month.  Algos Addiction Treatment uses a hybrid model, using urine drug screens, precerts, and counseling at no additional cost. With our model the cost (after the initial visit) is $155 per month and you must buy the medications that have a large range of costs as listed below.  This is a bargain compared to other clinics or methadone treatment centers and is far less than the $4500 a month ($150/day) heavy opioid users spend to afford heroin or illicitly obtained prescription opioids. There may also be coupons available from the manufacturer for the more expensive medications or from goodrx.com (may pull up the coupon from the app on your smart phone and show the pharmacist the numbers on the coupon without ever printing the coupon).  The pharmacist will not automatically check for coupons or lowest price- you need to do your homework beforehand. Also there are ways to lower costs by splitting pills or films.  For instance for a patient taking a total of 4mg a day of suboxone, buying the 2mg films (#60) and taking twice a day costs $263 for the month.  Buying one 4mg film (#30) and taking this once a day or splitting it and taking half twice a day costs $235 for the month.  Buying an 8mg film (#15) and taking 1/4 film twice a day or 1/2 film once a day costs $118 for the month.  Using Suboxone generic tabs 2mg twice a day costs $138 per month but using 1/2 of a suboxone generic tab 8mg each day costs $62 per month. Sometimes it is possible to use buprenorphine generic (without naloxone) tabs.  Using 2mg twice a day costs $86 whereas using 1/2 tab of an 8mg per day costs $40 per month.  Using a coupon from the manufacturer for the name brand suboxone used with insurance coverage can bring the cost of the same amount of suboxone films down to $25 per month.

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Below are the Aug 2016 cash costs published by goodrx.com using their app with their coupons.  Not all pharmacies listing their opioid prices on goodrx.com will honor these prices, but most will.  Insurance coverage may be used or goodrx.com coupons (online) may be used, and in some cases the price the patients pay using goodrx.com is less than their own insurance based payment charges them. These are prices for a 30 day supply.

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Suboxone 2mg films twice daily (BID):      $263

Suboxone 4mg films twice daily (BID):      $462

Suboxone 8mg film 1/2 BID                      $236

Suboxone 8mg films twice daily (BID):      $464

Bunavail   2.1 mg films once daily (QD):    $235 (equivalent to Suboxone 2mg twice daily)

Bunavail   4.2mg films once daily (QD) :    $235 (equivalent to Suboxone 4mg twice daily)

Bunavail   4.2mg films twice daily  (BID):  $492 (equivalent to Suboxone 8mg twice daily)

Suboxone generic tabs 2mg BID:              $138

Suboxone generic tabs 8mg QD:               $124

Suboxone generic tabs 8mg BID:              $242

Zubsolv 1.4mg BID (=2mg suboxone BID) $235

Zubsolv 2.9mg BID (=4mg suboxone BID) $463

Zubsolv 5.7mg BID (=8mg suboxone BID) $463

Buprenorphine 2mg BID (tabs)                  $86

Buprenorphine 8mg QD (tabs)                   $80

Buprenorphine 8mg BID (tabs)                  $155

Probuphine 80mg implants x 4 (6 months) $4950 (company will write off part of this)

Naltrexone 50mg tabs QD                         $33

Vivitrol 1 vial (one month)                         $1353

Clonidine 0.2mg #60                                $7

Lyrica 200mg #18                                    $116

Gabapentin 400mg #18                            $11

Topirimate 100mg #60                             $13

Amantadine 100mg #12                           $10

Zofran 4mg ODT #12                               $295

Phenergan (generic) 25mg tabs #24         $9

Adderall 20mg #120                                $83

Disulfuram 250mg #30                            $31

Mucormyst liquid 1200mg/day 5 vials        $66

Buspiron3 30mg#60                                $23

Clonazepam 1mg #60                              $7

Vistaril (hydroxyzine) 100mg #60             $35

Loperamide 2mg #12                               $12

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