How Much Does Naltrexone Cost With And Without Insurance?

Naltrexone is a prescription medication used to treat opioid and alcohol use disorders by blocking the effects of opioids and reducing alcohol cravings. The cost varies significantly depending on your insurance coverage, with generic naltrexone averaging around $101 for a 30-day supply without insurance, though insured patients may pay anywhere from nothing to the full price depending on their plan.

The medication comes in two forms: a daily oral tablet and a monthly injection given by a healthcare provider. While the oral version is available in both generic and brand-name options, the injectable form currently has no generic alternative and tends to be more expensive.

Find out more about taking Naltrexone for addiction treatment

Does Insurance Cover Naltrexone?

Many health insurance plans, including Medicare and Medicaid plans, offer coverage for generic naltrexone, brand name versions of naltrexone, or both.

Naltrexone may be covered by:

• private health insurance plans
• commercial insurance plans (i.e. employer-provided group plans)
• Medicare and Medicaid health plans
• military insurance (i.e. Tricare)

The cost of naltrexone may vary depending on the type of insurance plan you have, your insurance policy, prior authorization requirements, and the type of naltrexone received.

Cost Of Naltrexone Without Insurance

Naltrexone is a non-addictive medication that comes in the form of a pill, usually taken daily, or a monthly injection (Vivitrol). Oral naltrexone is cheaper in cost than Vivitrol, the brand name for the extended-release injectable form of naltrexone.

Cost Of Oral Naltrexone Without Insurance

Oral naltrexone is available as a generic drug, or may be prescribed under the brand names Revia or Depade. Without insurance, oral naltrexone can vary in cost from $25 to $108 for a 30-day supply of 50 milligram (mg) tablets. Factors that can affect this cost include where naltrexone is bought, the prescribed dosage, frequency of use, pharmacy coupons and discounts used, and more.

Cost Of Naltrexone Injection Without Insurance

The injectable form of naltrexone (Vivitrol) can be costly without insurance. A monthly dose of Vivitrol costs about $1,176.50 on average, or $14,112.00 per year. This estimated cost includes the cost of the drug, the administration of Vivitrol, and related services for Vivitrol administered through an opioid treatment program (OTP).

Cost Of Naltrexone With Insurance

Medication-assisted treatment (MAT) for alcohol and opioid use disorder with naltrexone is covered by many health insurance plans. With health insurance, the cost of naltrexone can be dramatically reduced, depending on the type of insurance plan you have and other eligibility requirements for coverage.

Cost Of Oral Naltrexone With Insurance

The cost of oral naltrexone with prescription drug coverage can vary depending on the health insurance provider and your insurance policy. Some insurance plans may fully cover the cost of oral naltrexone, while others may require copayment.

Cost Of Injectable Naltrexone With Insurance

Many health insurance plans offer coverage for Vivitrol, the injectable form of naltrexone. Copayment, prior authorization, and other eligibility requirements may apply. For those with copayment requirements, the manufacturer of Vivitrol now offers a Co-Pay Savings Program for eligible adults with public or private insurance. Not all health insurance providers that cover oral naltrexone cover Vivitrol. To confirm coverage, you’ll need to refer to your specific insurance policy or contact your insurer.

Factors That Affect The Cost Of Naltrexone

In addition to whether you have health insurance, there are a number of factors that can affect the cost of medications like naltrexone for substance abuse recovery.

What can affect the cost of naltrexone:

• Prescription Dosage: Higher or more frequent dosing schedules will increase your monthly medication costs. Your doctor will prescribe the most effective dose for your specific situation, but this directly impacts how much you’ll pay each month.
• State of Residence: Medication prices can vary significantly from state to state due to different pharmacy regulations, state Medicaid programs, and regional competition among pharmacies. Some states also have prescription assistance programs that can help reduce costs.
• Drug Formulation (i.e. pill vs. injection): The injectable form of naltrexone (Vivitrol) is typically much more expensive than the daily oral tablets. While the injection offers the convenience of monthly dosing and eliminates concerns about daily compliance, it comes with a higher price tag since there’s no generic version available.
• Treatment Setting (e.g. outpatient clinic, inpatient rehab program): Outpatient clinics, inpatient rehab programs, specialty addiction treatment centers, and regular pharmacies may all have different pricing structures and may offer different types of financial assistance or payment plans.
• Generic or Brand Name Version: Generic naltrexone is significantly cheaper than brand-name versions like ReVia. For the oral form, choosing generic can save you hundreds of dollars per year, while the injectable form currently only comes as the brand-name Vivitrol.
• Insurance Provider and Prescription Drug Coverage Policy: Different insurance companies have varying levels of coverage for addiction medications. Some may cover naltrexone fully as a preferred drug, while others may require prior authorization, step therapy, or higher copayments. Your specific plan’s formulary determines how much you’ll pay out of pocket.
• Pharmacy Coupons: Many pharmacies offer discount programs, and pharmaceutical companies sometimes provide patient assistance programs or coupons that can significantly reduce costs, especially for people without insurance or those with high copayments.

Not all insurance companies cover naltrexone the same. Insurance deductibles, co-payment, and other insurance-related requirements for covering costs may apply. In addition, factors such as the dosage prescribed and whether you are receiving a brand name or generic drug product can affect drug costs.

Naltrexone Cost FAQs

Find answers to frequently asked questions about the cost of naltrexone.

❓ Is Naltrexone Covered By Medicaid?

✔️ Naltrexone (oral and injectable) is covered by Medicaid in all 50 states and the District of Columbia.

❓ Does Medicare Cover Naltrexone?

✔️ Medication-assisted treatment (MAT) with naltrexone is covered by Medicare Part D and Medicare Part A, B, and C when administered in approved treatment settings.

❓ Does Tricare Cover Naltrexone?

✔️ TRICARE offers prescription drug coverage for oral naltrexone, which is available in generic and brand name versions.

Vivitrol, the extended-release formulation of naltrexone, is not covered by TRICARE.

❓ How Much Is A Prescription For Naltrexone?

✔️ The average cost of a prescription for oral naltrexone ranges from $20 to $109 for a 30-day supply, without insurance.

Pharmacy coupons, drug discounts, and prescription drug coverage offered through a health insurance plan may help reduce naltrexone prescription costs.

Written by the Addiction Resource Editorial Staff