How Much Does Vivitrol Cost Without Insurance
Vivitrol's manufacturer wholesale price is roughly $1,500 per shot. Patients almost never pay that. Three programs reduce real out-of-pocket cost: the manufacturer copay assistance program, state-funded Vivitrol programs in some states, and sliding-scale fees at SAMHSA-funded facilities. The actual cost most patients experience depends on which of those they qualify for.
| Cost component | Sticker price | With manufacturer copay program | With Medicaid |
|---|---|---|---|
| Vivitrol drug cost | ~$1,500 per shot | As low as $5 per shot | $0 copay typically |
| Office visit | $100-$300 | $100-$300 (often waived) | $0-$5 |
| Initial labs (LFTs, drug screen) | $80-$200 | $80-$200 | $0-$10 |
| Naloxone challenge (if done) | $50-$150 | $50-$150 | $0 |
| Total first month | ~$1,750-$2,150 | ~$235-$655 | ~$0-$30 |
| Total monthly maintenance | ~$1,600-$1,800 | ~$105-$305 | ~$0-$10 |
The sticker price reality
Average wholesale price (AWP) for one 380mg dose of Vivitrol is approximately $1,500. The pharmacy or clinic acquisition cost is somewhat lower than AWP. Patients without any coverage who walk in and pay cash will see something close to AWP on their bill, though some clinics offer discounts to self-pay patients.
On top of the drug cost, the patient pays for the office visit ($100 to $300), initial labs (liver function tests at minimum, $80 to $200), and a naloxone challenge if performed ($50 to $150). The all-in first-month cash cost is $1,700 to $2,150 for a fully self-pay patient with no programs.
The Alkermes copay assistance program
Alkermes runs a copay assistance program called Vivitrol Cost Support Program. For patients with commercial insurance, the program brings out-of-pocket cost down to $5 per shot for up to 12 shots per year. The program does not work for patients on Medicaid, Medicare, or any other federal program.
The catch: the patient still needs commercial insurance that covers Vivitrol, and the program covers only the patient share, not the full drug cost. Patients without any insurance cannot use it.
The Vivitrol2GO patient assistance program
For uninsured or underinsured patients who do not qualify for the copay program, Alkermes offers the Vivitrol2GO patient assistance program. Patients who meet income requirements (typically up to 400 percent of the federal poverty level) can receive Vivitrol at no cost. The program requires application paperwork and prescriber documentation. Approval typically takes 1 to 3 weeks.
State-funded Vivitrol programs
Several states fund Vivitrol provision for specific populations:
- Florida funds Vivitrol for probationers in community-based treatment through FADAA.
- Connecticut, New York, and several other states fund Vivitrol through state opioid response grants for re-entry populations.
- Many state corrections systems now provide Vivitrol pre-release as a standard intervention for incarcerated individuals with OUD.
Sliding scale at SAMHSA-funded facilities
Facilities that receive SAMHSA Substance Abuse Block Grant funding are required to offer sliding-scale fees based on income. Many of these facilities can provide Vivitrol at substantially reduced cost or no cost to qualifying patients. Look for the SAMHSA service code "SS" (sliding scale) on facility listings.
What the cost picture actually looks like for most patients
Patient with Medicaid: typically $0 to $10 per shot total. The largest patient population for Vivitrol.
Patient with commercial insurance and the Alkermes copay card: $5 per shot for the drug, plus normal office visit copay. Usually $20 to $50 total per month.
Patient without insurance using Vivitrol2GO: $0 for the drug if approved, plus office visit cost (sometimes also reduced or waived at participating facilities).
Patient without insurance and not eligible for assistance programs: $1,500 to $1,800 per month. This is the rare worst case.
Why the sticker price exists if no one pays it
The $1,500 AWP is what insurance companies pay (after their negotiated rebates) and what unsubsidized self-pay patients see. The complex pricing exists because Alkermes negotiates different prices with different payers. Medicaid programs in particular get statutory rebates that reduce the effective cost considerably.
For patients, the practical takeaway is simple: if you want Vivitrol and have any insurance, your cost is small. If you do not have insurance, apply to the patient assistance program before paying retail.