Probuphine Pricing: Understanding the Sticker Price
Unlike an oral medication you pick up at a pharmacy, the Probuphine implant is a medical device that must be inserted by a specially trained and certified healthcare provider in a clinical setting. This means its total cost involves several components, including the price of the implants themselves and the fees for the medical procedure.
The search results indicate the following price points for the medication itself:
- Average Wholesale Price (AWP): A six-month course of Probuphine (four implants) was listed with an AWP of $5,940. This is the price paid by distributors or healthcare facilities, not necessarily the final price for a patient.
- Other Reported Prices: Various sources have cited the six-month cost of the four-implant series at around $5,000 to $5,177. A year of treatment would therefore cost roughly double, or about $10,000.
- Procedure Cost: These prices do not include the cost of the office visit for insertion and later removal, which are separate fees. The insertion procedure itself can take 15 to 20 minutes.
The Significant Impact of Insurance and Patient Assistance
For most people, the final cost of Probuphine is heavily influenced by their insurance plan. Major national insurance companies have indicated they would cover the treatment, but coverage details and out-of-pocket costs can vary widely.
Factors affecting your final price include:
- Your specific plan's coverage: What your plan covers, its copayments, deductibles, and coinsurance percentages will dictate your out-of-pocket expense.
- Justification of treatment: Some insurers may question the cost-effectiveness of an expensive implant for a patient who is already stable on cheaper oral buprenorphine.
- Financial assistance: Manufacturer patient assistance programs (PAPs) or copay cards may exist to help eligible patients reduce their costs. Historically, Braeburn Pharmaceuticals, the manufacturer at the time of Probuphine's release, indicated it would offer rebates to insurers and assistance to patients.
Comparison of Buprenorphine Formulations
To understand the cost of Probuphine, it is helpful to compare it to other forms of buprenorphine for treating opioid use disorder (OUD). This highlights the trade-offs between convenience, adherence, and cost.
| Treatment Formulation | Delivery Method | Estimated Six-Month Cost (Without Insurance) | Key Advantages | Key Disadvantages |
|---|---|---|---|---|
| Probuphine | Subdermal implant (4 rods) | ~$5,000 - $6,000 (medication cost only) | Sustained, consistent release for 6 months; no daily dosing; reduced risk of misuse/diversion; no missed doses | Higher upfront cost; requires a minor surgical procedure for insertion/removal; potential for implant site complications |
| Buprenorphine/Naloxone (Generic Sublingual) | Dissolvable film or tablet under the tongue | ~$570 (using ~$95/month as per 2020 data) | Much lower cost, especially generic versions; no procedure required | Requires daily, consistent dosing; risk of diversion; adherence can be an issue |
| Sublocade (Buprenorphine ER Injection) | Monthly Subcutaneous Injection | ~$11,500 (based on manufacturer price ~$1,920.50/month) | Monthly injection for sustained release; no daily dosing; eliminates risk of diversion or missed doses | Higher cost than generic sublinguals; still requires monthly provider visits |
Seeking Financial Assistance
For individuals concerned about the cost of medication-assisted treatment (MAT), various programs and resources may offer help. While Probuphine may no longer have a specific manufacturer's patient assistance program, aid is available for buprenorphine treatment in general.
- Manufacturer Programs: Some buprenorphine manufacturers offer patient assistance programs (PAPs) or copay cards for eligible patients, such as INSUPPORT for SUBOXONE Film. These programs often have income and insurance status requirements.
- State Programs: State-specific assistance programs, like New York's Buprenorphine Assistance Program (BUPE-AP), may cover the cost for uninsured or underinsured residents.
- Federal and Non-Profit Resources: Websites like RxHope and professional organizations can provide information on patient assistance options. Organizations like the Foundation for Opioid Response Efforts (FORE) also publish resources related to the affordability of MAT.
Conclusion
The cost of the Probuphine implant is significantly higher than that of generic daily buprenorphine formulations due to its unique, long-acting delivery system. With average wholesale prices for a six-month course hovering around $5,000 to $6,000, the final out-of-pocket cost for a patient is heavily dependent on their insurance coverage and any available patient assistance. While the upfront cost is substantial, the benefit of improved adherence and reduced risk of diversion for six months may outweigh the higher price for some individuals. It is crucial for patients to discuss all treatment options, including newer alternatives like Sublocade, with their healthcare provider and to contact their insurance company and potential patient assistance programs to understand their specific financial obligations.
