“Insurers and pharmacy benefits managers currently choose which MAT drugs they will cover. Express Scripts Holding Co., the nation’s largest pharmacy benefit manager, includes both methadone and buprenorphine in its formulary, while rival CVS Health only covers methadone.
Other payers reportedly do not cover methadone, which costs $4,000 per year, and is less expensive than buprenorphine. The cost comes out to around $76 a week for a daily dose. Some say that’s reasonable when compared to the estimated $193 billion in annual costs related to drug addiction, according to a 2012 analysis by the White House Office of National Drug Control Policy (PDF).
“The cost of the drug itself is fairly trivial,” said Martin Iguchi, adjunct senior behavioral scientist at the RAND Corp. “Considering that it’s something people will receive seven days a week, it seems like a relative bargain; compared to almost anything else in medicine, it’s a very low cost.”
Source: ModernHealthcare.com – December 30, 2015