How to save on Xiidra prescriptions

In this article:

• How much does Xiidra cost?
• Is Xiidra covered by insurance?
• How to save money on Xiidra
• Is there a cheaper alternative to Xiidra?

In this article

• How much does Xiidra cost?
• Is Xiidra covered by insurance?
• How to save money on Xiidra
• Is there a cheaper alternative to Xiidra?

 Xiidra is the brand name for lifitegrast, an eyedrop medication that’s FDA approved to treat dry eye syndrome (DED). Dry eye syndrome impacts 5% to 17% of the population and is more common in older age. When you have dry eye syndrome, you may experience dryness, irritation, eye watering, and inflammation. The symptoms can impact your ability to read, drive, use a computer, and participate fully in daily life.

Xiidra can be a game-changer for people with dry eye syndrome, but it can be expensive. Not only that, but there isn’t a cheaper, generic version of the medication available and not all insurance companies will cover it. Here, we’ll go over everything you need to know about Xiidra insurance coverage and how to save on Xiidra.

How much does Xiidra cost?

The cash price for Xiidra can be steep. The average retail value of Xiidra is about $1,030 for 60, 5% solutions. This is the cost of Xiidra without insurance, before any discounts.

Sometimes medications cost less if you get a generic version of the drug, but there are currently no approved generics of Xiidra. The good news is there are ways to save on Xiidra, including Xiidra savings cards, manufacturer discounts, and more. 

Is Xiidra covered by insurance?

The answer to whether or not Xiidra is covered by insurance is: It depends. Whether or not Xiidra is covered by your health insurance plan depends on factors such as the type of health insurance you have, your specific plan policies, and the drug tier in which your insurance company categorizes Xiidra. Even when Xiidra is covered, you might have other out-of-pocket expenses, like copayments and deductibles. Insurance companies also change the tier and coverage on their schedule so the out-of-pocket cost can change at future refills. 

 Some employee-based health insurance plans and marketplace plans cover Xiidra, while others do not. According to Haris Dzubur OD, optometrist at OkoEyes.com, Medicaid recently added coverage for Xiidra, and Medicare often covers it too.

As noted on the Xiidra manufacturer’s website, 7 out of 10 Medicare patients have Xiidra coverage. But even then, there may be hurdles to pass through. “With the new Medicare deductibles, Xiidra may be covered, but unaffordable for patients,” Dr. Dzubur shares.

Even when your health insurance covers Xiidra, there are often eligibility requirements that need to be met for coverage to happen.

Step therapy

Step therapy is where you have to try other, less expensive medications before the medication you want is approved. This is often necessary with Xiidra. “Patients must have tried and failed up to three OTC drops to treat Dry Eye—artificial tears, a topical gel, and sometimes an antihistamine,” Dr. Dzubur explains. 

Documentation of medical necessity

Often, your healthcare provider needs to show that taking Xiidra is medically necessary for you. For Xiidra to be covered, insurance companies often “require a proper dry eye diagnosis and clinical findings,” Dr. Dzubur says. “Sometimes clinical notes are required.”

How to save money on Xiidra

Xiidra can be costly if you are paying for it out of pocket. However, there are ways to save on the cost of the medication. Here are some options.

Free Xiidra coupons

SingleCare discount cards can save you substantial amounts of money on your Xiidra prescription. Without a SingleCare card, Xiidra costs an average of $1,030 for 60, 5% solutions of Xiidra. But with a SingleCare discount card, you can pay as little as $617 for 60 5% solution containers of Xiidra at Kroger.

Using a SingleCare discount card is simple. You look up the medication you want covered and text, print, or email the SingleCare discount card. You can also use the SingleCare app to search for and view your discount card. Then, when you go to the pharmacy to pick up your prescription, you present the savings card. Using a SingleCare card is free, with no hidden costs.

Medicare or Medicaid savings

People who are on Medicare or Medicaid can sometimes use governmental programs to reduce medication costs. For example, the Extra Help program helps people with limited income afford their prescription drugs. Some individuals automatically qualify for services through the Extra Help program, including those on full-coverage Medicaid, individuals who receive state assistance with paying Medicare Part B premiums, and those who receive Supplemental Security Income (SSI). But you can also apply for Extra Help on the Medicare.gov website. For more information, you can also contact your Medicare or Medicaid insurance provider.

Manufacturer savings

The Xiidra manufacturer offers a savings program. This program is for people who have commercial insurance to save money on their medication. The offer is a $0 copayment on the first 90 days of a prescription. Importantly, this program is not for people who receive government sponsored insurance, including Medicare or Medicaid. More information can be found on the Xiidra website.

Is there a cheaper alternative to Xiidra? 

If you are struggling to afford Xiidra, consider Xiidra alternative prescription medications. Dr. Dzubur’s top recommendations include Cequa, Vevye, or a newer option, Tryptyr. These are prescription eye drop medications that treat dry eyes. They each work differently, though, so it’s best to discuss these alternatives with your doctor.

You can also ask your healthcare provider or pharmacist about other treatments for dry eye, such as:

• Over-the-counter eye drops, known as artificial tears
• Over-the-counter moisturizing gels, ointments, and pads
• Warm eyelid compresses
• Lifestyle changes, like avoiding smoke and air-conditioning
• Using a humidifier to moisten the air
• Taking screen time breaks to rest your eyes
• Making sure to stay well hydrated and drinking at least 8 glasses of water per day
• Taking dietary supplementation with omega-3 fatty acids. 
• N-office surgeries for dry eye, like punctal plugs
• Taping your eyelids shut at bedtime if your lids do not seal while asleep

Either way, if you are looking into alternative dry eye medications or treatments, you should always consult with a healthcare provider who knows your medical history and can make recommendations that are best for your health and well being. Your healthcare provider, optometrist, or pharmacist may also have tips for how to save on Xiidra and may be able to work with your health insurance company to increase the chances of the drug being covered.