Vivitrol costs roughly $1,590 to $1,760 per injection without insurance, depending on where you receive it. Since the medication is given once a month, that puts the annual cost somewhere around $19,000 to $21,000 for a full year of treatment. The price can drop significantly with insurance, copay programs, or patient assistance, and some people pay nothing at all.
What You’ll Actually Pay Without Insurance
The manufacturer’s wholesale list price for a single 380 mg dose of Vivitrol is $1,590.22. By the time it reaches a provider’s office or clinic, the retail price typically lands around $1,758. That’s the cost for one injection, and you need one every four weeks.
Unlike most prescriptions, you can’t just pick up Vivitrol at a pharmacy counter. It’s a specialty medication that has to be injected by a healthcare provider, so the price you see often includes both the drug itself and the administration fee from your doctor’s office or clinic. These office visit charges vary but can add $50 to $200 or more on top of the drug cost.
Standard pharmacy discount cards like GoodRx generally don’t work for Vivitrol because it’s classified as a provider-administered specialty medication. That removes one of the most common tools people use to lower prescription costs.
How Insurance Changes the Price
Most commercial insurance plans and Medicaid cover Vivitrol, though the amount you owe out of pocket depends entirely on your plan. Some plans cover it under the medical benefit (since it’s an injection given in a clinical setting) rather than the pharmacy benefit, which can change your copay or coinsurance structure. If your plan covers it under medical benefits, you may owe a percentage of the allowed amount rather than a flat copay.
Prior authorization is common. Your insurance company may require documentation that you meet specific criteria before approving coverage, which can delay your first injection by a few days to a couple of weeks.
Copay Programs and Financial Assistance
Alkermes, the company that makes Vivitrol, offers a copay savings program that can reduce your cost to $0 per month. The program covers up to $500 per injection for up to 12 injections per calendar year, meaning a maximum annual savings of $6,000. For many people with commercial insurance who face a copay in the $100 to $500 range, this effectively eliminates out-of-pocket costs.
If you’re uninsured or underinsured, Alkermes also runs a patient assistance program for people who meet income and coverage criteria. Eligibility is based on federal poverty level guidelines and requires an FDA-approved diagnosis. You can reach the program through Alkermes’ support line at 1-800-848-4876 or through the Vivitrol website. Many addiction treatment centers and community health clinics also receive grant funding that covers part or all of the cost for qualifying patients.
How Vivitrol Compares to Oral Naltrexone
Vivitrol contains the same active ingredient as oral naltrexone tablets, just delivered in a slow-release injection instead of a daily pill. The cost difference is dramatic. A month’s supply of oral naltrexone (50 mg tablets) runs about $98 without insurance. Vivitrol costs roughly 18 times more for the same month of treatment.
The trade-off is adherence. Taking a pill every day requires daily motivation, and skipping doses is common in addiction treatment. The monthly injection removes that daily decision entirely. For opioid dependence in particular, research consistently shows that the extended-release injection keeps more people in treatment compared to the oral version. Whether that clinical advantage justifies the price gap depends on your situation, your coverage, and how confident you are in sticking with a daily medication.
Why the Price Is So High
Vivitrol’s cost reflects the extended-release delivery technology, not the drug itself. Naltrexone as a compound has been available in generic form since the 1990s and is inexpensive. What Alkermes patented is the microsphere injection system that releases the medication slowly over four weeks. There is currently no generic version of the injection, so Alkermes faces no price competition for the extended-release formulation.
The monthly dosing schedule also means the drug is typically billed through medical benefits rather than pharmacy benefits, placing it in a category where pricing transparency is lower and negotiation works differently than at a retail pharmacy.
Practical Ways to Lower Your Cost
- Check both benefit types. Ask your insurer whether Vivitrol is covered under your medical benefit or pharmacy benefit, since the copay structure can differ significantly between the two.
- Apply for the copay card first. If you have commercial insurance, the manufacturer’s copay program is the fastest way to reduce costs. It can be combined with your existing coverage.
- Contact community treatment centers. Federally qualified health centers and opioid treatment programs often receive SAMHSA grants specifically earmarked for medication-assisted treatment, which can cover Vivitrol at no cost to you.
- Ask about the patient assistance program. If you have no insurance or your plan denies coverage, Alkermes’ program may provide the medication free based on income eligibility.
- Consider oral naltrexone as a bridge. If cost is a barrier and you’re waiting for assistance approval, starting on the oral tablet at roughly $98 per month keeps you on the same medication while logistics get sorted out.