OBJECTIVES: Buprenorphine/naloxone (BUP/NAL) combination for the treatment of opioid dependence is available in Film (since September 2010) and tablet formulations. Earlier studies showed that treatment with film leads to better persistence and lower healthcare costs compared to BUP/NAL tablet. Higher costs were related to higher relapse and reinitiation rates found in the tablet treated groups.   Based on these scientific analyses, a budget impact analysis was built to assess the health care expenditures related to new patients entering treatment in scenarios characterized by different market shares of the two BUP/NAL formulations. METHODS: A Markov model was structured tracking a cohort of patients initiating opioid dependence treatment with BUP/NAL film or BUP/NAL tablet through successive phases of treatment: initiation, maintenance, discontinuation, off treatment and reinitiation. Transition probabilities and resource utilization were estimated from a private insurance claims database. The total healthcare expenditure over five years was predicted for 1,000,000 lives for the following scenarios: 1) 100% market share BUP/NAL film formulation, 2) 100% market share BUP/NAL tablet formulation broken between all BUP/NAL tablet formulations currently available in the market. RESULTS: In the first year, costs of medication acquisition were found to be  lower in the Scenario 1. Costs of laboratory tests were higher. Nevertheless, this difference was outweighed by lower costs of outpatient care (-4.7%) (-US$88,493), inpatient psychiatric care (-51.2%) (-US$1.8 million) and inpatient non-psychiatric care (-16.7%) (-US$703,780). Scenario 1 total healthcare costs were were19.7% (US$2.8 million) and 16.5% (US$17.2 million) lower in the first year and cumulatively over five years, respectively. CONCLUSIONS:  Treatment with buprenorphine/naloxone film results in less healthcare resource utilization and lower total cost burden for private insurers when compared to treatment with buprenorphine/naloxone tablet.