Dispensing Methadone Can Yield Good Returns on Investments for Pharmacies

Overview

Methadone—proved to significantly reduce overdose deaths and support treatment retention—is a lifesaving medication for people with opioid use disorder (OUD). But methadone is generally available only through opioid treatment programs (OTPs). OTPs are specialty treatment settings regulated at both the federal and state levels, and they can be difficult to access, even for patients actively seeking care.

Federal regulation allows community pharmacies to function as OTP satellite facilities known as medication units. Pharmacists working at these medication units may dispense methadone for OUD, and the Substance Abuse and Mental Health Services Administration reinforced support for this model of care in a June 2026 advisory.¹

But few, if any, pharmacies in the United States have partnered with OTPs to dispense methadone for OUD. Increasing the number of satellite facilities throughout the country would meaningfully improve patient access to this evidence-backed treatment.

Brandeis University, with support from The Pew Charitable Trusts, examined how pharmacies can start medication units,² the costs associated with dispensing methadone, and the impact on existing OTPs and patients. The research showed that:

	1. Pharmacy-based medication units dispensing methadone for OUD are legally viable unless prohibited by state law.
2. Start-up costs are reasonable for many pharmacies interested in dispensing methadone.
	3. Pharmacies that become medication units can receive good returns on investment in fewer than three years.
4. Patients seeking methadone treatment appreciate the convenience of using pharmacies to access care, as other research has shown.3

Endnotes

1. Substance Abuse and Mental Health Services Administration, “Expanding Access to Medications for Opioid Use Disorder: The Role of Pharmacists and the Settings in Which They Work,” 2026, https://library.samhsa.gov/sites/default/files/moud-pharmacies-pep26-02-003.pdf.
2. Brandeis University Heller School for Social Policy and Management, “Startup Costs and Profits of Pharmacy-Based Medication Units for Opioid Use Disorder Treatment,” https://heller.brandeis.edu/opioid-policy/pdfs/brandeis_roi-pharmacymedicationunit-1.pdf.
3. Maureen T. Stewart et al., “Key-Informant Perspectives on Pharmacy-Based Methadone Treatment for Opioid Use Disorder in the U.S.,” Health Affairs 44, no. 9 (2025): 1164-72, https://doi.org/10.1377/hlthaff.2025.00344.