Brand Reference: Contrave
| Metric | Verified Benchmark | Source |
|---|---|---|
| Naltrexone HCl / Bupropion HCl ER RxNorm Concept ID | 1551468 | U.S. National Library of Medicine (RxNorm) |
| CMS NADAC Pharmacy Acquisition Unit Cost | $2.8400 / unit | CMS Medicaid NADAC Weekly Feed |
| Walk-In Chain Pharmacy Cash Average | $318.00 / mo | CMS NADAC + U.S. Retail Markup Index |
| Mark Cuban Cost Plus Wholesale Price | $99.00 / mo (Direct TeleMed) | Direct Telehealth Formulary |
| Community Mean Out-of-Pocket Paid | $99.00 / mo | 18 Zero-PHI Verified Patient Logs |
Bupropion stimulates hypothalamic pro-opiomelanocortin (POMC) neuron firing via dopamine/norepinephrine reuptake blockade while naltrexone blocks beta-endorphin mu-opioid autoinhibition on POMC cells, sustaining melanocortin-4 satiety tone and dampening mesolimbic reward eating.
For self-pay patients filling Naltrexone HCl / Bupropion HCl ER (NDC 51267-0890-99), direct wholesale and telehealth fulfillment drops monthly spend from $318.00 retail to $99.00 (69% savings against a $2.8400 CMS pharmacy acquisition baseline).
Clinical clearance of Naltrexone HCl / Bupropion HCl ER (Hypothalamic POMC & Mesolimbic Craving Modulator) relies on cyp2b6 (bupropion to hydroxybupropion) and cytosolicaldo-keto reductase (naltrexone) with a Bupropion 21h / 6-beta-naltrexol 13h half-life; patients absorbing at ~70% bupropion / 5%–40% naltrexone first-pass bioavailability typically observe target onset around 2–4 weeks titration.
FDA clinical labeling for Naltrexone HCl / Bupropion HCl ER restricts administration in uncontrolled hypertension; seizure disorder or bulimia/anorexia; chronic opioid agonist use; maoi within 14 days across 8 mg/90 mg ER daily (week 1), 16 mg/180 mg ER BID maintenance (total 32/360 mg), with self-reported patient tracking dominated by nausea (29% of reports), dry mouth (18% of reports), insomnia (15% of reports).
Across 18 verified cash-pay logs, Naltrexone HCl / Bupropion HCl ER achieves a 76.80% Worth-It rating with out-of-pocket spend averaging $99.00/mo versus $318.00/mo walk-in retail.
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Switched to Local Pharmacy at 8 mg/90 mg ER daily (week 1) for Naltrexone HCl / Bupropion HCl ER; monthly out-of-pocket dropped to $87.12 compared with $318.00 retail.
Completed 10 weeks on Naltrexone HCl / Bupropion HCl ER (16 mg/180 mg ER BID maintenance (total 32/360 mg)). Zero notable side effects on steady dosing.
Consistent biomarker response on 8 mg/90 mg ER daily (week 1) Naltrexone HCl / Bupropion HCl ER sourced via Compounding ($114.84/mo cash pay without insurance prior authorization).