OBJECTIVES: Buprenorphine/naloxone (BUP/NAL) combination is a treatment for opioid dependence. The dose of BUP/NAL should be adjusted to a level that suppresses craving and opioid withdrawal symptoms and holds the patient in treatment.  The objective of this study was to estimate the impact of BUP/NAL dosing on treatment persistence, resource utilization and healthcare charges among privately insured patients.  METHODS: A retrospective cohort analysis was conducted on a private health insurance claims database (ClinformaticsTM DataMart) from January 2005 to November 2012. Patients were classified in two groups based on average daily dose using the median as cut-off value and matched according to baseline characteristics. Discontinuation was defined as a gap of at least 31 days without prescription renewal following the theoretical end date of the previous prescription. Resource use and related charges were calculated over the 12-month period after the date of treatment initiation.  RESULTS: The median of the average daily dose was 15.7mg/day. The matching algorithm resulted in the selection of 1,949 patients in each group, with 64% of males, and an average age of 34 years.   Patients in the high dose group had a 9% lower chance of discontinuation compared to patients treated with low dose, after adjustments (p=0.0278). The probability of psychiatric hospitalization in the year following the treatment initiation was 41% lower in the high-dose patients (p<0.0001) and health care charges were 23% lower (p=0.0061).  CONCLUSIONS: Treatment duration was longer among patients treated with doses above 15.7mg/day. Despite higher pharmaceutical charges, patients treated with higher doses had significantly lower total healthcare charges in the 12 months after initiation related to lower rates of hospitalizations.