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Updated February 07, 2014
Suboxone

Suboxone Patient Assistance Program

This program provides brand name medications at no or low cost.

Provided by: Reckitt Benckiser Pharmaceuticals, Inc.

PO Box 220281
Charlotte, NC 28222-0281

TEL: 888-898-4818


ALT PHONE:
FAX: 888-407-9788
Languages Spoken:

English

Program Website
 

Patient Assistance Applications

 Suboxone Patient Assistance Program: Contact program

 

Medications

  • Suboxone Film; Sublingual 2mg/0.5mg, 8mg/2mg (buprenorphine/naloxone)
 

Eligibility Requirements

Insurance Status Must have no prescription coverage
Those with Part D Eligible? Not specified
Income At or below 250% of FPL
Diagnosis/Medical Criteria Opioid dependence
US Residency Required? Yes
   

Application

Obtaining Doctor/Doctor's office must call
Receiving Faxed
Returning Mail or fax
Doctor's Action Complete section, sign
Applicant's Action Complete section, sign, attach a copy of proof of income
Decision Communicated Doctor notified
Decision Timeframe Not specified
   

Medication

Amount/Supply Up to 1 month supply
Sent To Patient sent card to be used at pharmacy
Delivery Time Not specified
Refill Process Patient presents voucher/card to pharmacy for each refill
Limit One year
Re-application Not specified
   

Additional Information

The patient must be 16 years or older.
A doctor can only have three patients on the program at a time.