Don't qualify for this program? Visit the DBAs to look for financial assistance based on your diagnosis.  
Updated December 19, 2014
 

Suboxone

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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, 4mg/1mg, 8mg/2mg, 12mg/3mg (buprenorphine/naloxone)
 

Eligibility Requirements   

Insurance Status Must be uninsured
Those with Part D Eligible? No
Income At or below 250% of FPL
Diagnosis/Medical Criteria Opioid dependence
US Residency Required? Yes
   

Application

Obtaining Patient/Doctor must call to register and enroll
Receiving Faxed
Returning Fax or mail
Doctor's Action Complete section and sign
Applicant's Action Complete section, sign, attach a copy of proof of income
Decision Communicated Patient and Doctor are notified
Decision Timeframe 2 business days, once application process is complete
   

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 Up to one year
Re-application This is a one time program
   

Additional Information

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

This program also provides copay assistance.