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Suboxone Film Patient Assistance Program

This program provides brand name medications at no or low cost

Provided by: Indivior Inc.

PO Box 220281
Charlotte, NC 28222-0281

TEL: 888-898-4818

FAX: 888-407-9788
Languages Spoken:


Program Website


Program Applications and Forms

Suboxone Patient Assistance Program: Contact program



  • Suboxone film; sublingual (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


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


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.

Updated October 17, 2018