There is significant money at stake. Under a law passed by Congress in 2016, the Trump administration is sending $1 billion to states to deal with the epidemic over the next two years, with directions to prioritize so-called medication assisted treatment. Mr. Trump’s opioid commission recently implored Congress to swiftly appropriate more money.
Suboxone, made by Indivior, is the older, cheaper, and much more widely studied and used of the two medications. The manufacturer of Vivitrol, Alkermes, has tried to catch up by marketing its drug as a cleaner alternative, emphasizing that Vivitrol is the only federally approved addiction medication that does not contain an opioid.
Vivitrol is also the most expensive addiction medication, with Medicaid paying about $500 per shot, according to Alkermes, and private insurers paying $1,000. Suboxone tends to cost a third to half as much. Another addiction medication approved by the Food and Drug Administration, methadone, is much cheaper, but people who take it have to go to specially licensed clinics for their daily dose. The study focused on Vivitrol and Suboxone because both can be prescribed by primary care doctors, although a federal waiver is needed to prescribe Suboxone.
Using free samples and millions of dollars in political donations, Alkermes has pushed for the use of Vivitrol in drug courts and jails, where Suboxone is often not allowed. Vivitrol has won fans among many law enforcement officials who see Suboxone as simply replacing one addiction for another. Suboxone is also more likely to be diverted into a black market, though addiction experts say that people who use it are trying to stave off withdrawal, not get high.
But Alkermes’ strategy has drawn attention from lawmakers and law enforcement officials concerned that it is encouraging misconceptions about Suboxone as it tries to promote Vivitrol.
Last month, Senator Kamala Harris…