How much is Restasis without insurance?

Is Restasis covered by insurance? | How much does Restasis cost without insurance? | How to get Restasis without insurance

Restasis is a prescription eye drop with the active ingredient cyclosporine approved by the U.S. Food and Drug Administration (FDA) for treating chronic dry eye disease. This condition causes reduced tear production. Restasis may also work for inflammation and dry eyes that stem from other eye conditions. On average, it costs $798 for a 30-day supply of single-use emulsions. However, there’s a generic version, plus a few different ways to reduce the medication’s cost. 

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What is the generic for Restasis?

The FDA approved a generic version of Restasis in February 2022. It comes in 0.05% single-use vials, the same formulation as Restasis. 

But the question is whether it’s equally effective. “I would typically say for eye drops, typically branded medication works better than the generic medications across the board, whether we’re talking about glaucoma or dry eye,” says Dr. Bobby Saenz, OD, MS, FAAO, co-founder of LASIK San Antonio and professor at the Rosenberg School of Optometry. 

Plus, other formulations might not be consistent, says Dr. Yuna Rapoport, MD, MPH, founder of Manhattan Eye. “Since it’s manufactured in many different locations, it is sometimes inconsistent in its production—the viscosity and the amount of liquid in each bottle between manufacturers,” she says. 

However, the FDA took these potential inconsistencies into account when approving the generic form of Restasis. Some medications, like eye drops, can be more complex to make as a generic. So, while there are sure to be differences between manufacturers, there are processes in place to ensure that all parts of the formula are as effective as possible.

Is Restasis covered by insurance?

“Restasis is typically covered by private insurance and Medicare. The specific type of plan within private insurance providers and Medicare can affect coverage,” says Dr. Rapoport. So check your plan’s formulary to confirm the details.

According to Dr. Saenz, Restasis may have broader insurance coverage than other prescription dry eye medications. “If you look at the data on which dry eye medication has the big market share, it’s still Restasis, even though newer ones have come out,” he says. “And the reason for that, I think, is because Restasis has the best insurance coverage.”

How much does Restasis cost without insurance?

Every health insurance plan has a unique formulary—a list of the drugs it covers in part or in full. Formularies divide those medications into tiers. The lower tiers (generic drugs) typically cover more of the cost than those for the higher tiers (specialty medications). Due to Restasis being a branded medication, certain insurance plans may only partially cover its expenses. Copayments, deductibles, and coinsurance can differ, and there is a possibility that some plans may not include coverage for Restasis.

For people whose plans don’t cover Restasis, the out-of-pocket cost of Restasis averages $798 for 60 single-use vials, a one-month supply. Or, for one 5.5ML of 0.05% bottle of Restasis Multidose, the average retail price is $792.83. That’s just over $26 per day and $9,570 per year for either dosage. 

Restasis is an ongoing treatment. “What’s happening with Restasis is you’re trying to decrease inflammation,” Dr. Saenz says. “If inflammation is left on the eye, dry eye gets worse over time, which means that Restasis is a chronic medication. The longer a patient is on it, the better it works.” So, those repeat purchases can add up over months and years of use. 

Insurance coverage is the most significant factor that influences the price of Restasis. However, Restasis prices can sometimes vary between pharmacies as well. A U.S. Public Interest Research Group report concluded that some pharmacies can charge a few hundred dollars more than others.

That said, several alternatives might be more affordable in certain situations.

Prescription drug prices often change. These are the most accurate medication prices at the time of publishing. The listed price without insurance references the price of brand-name drugs (unless otherwise specified). The listed SingleCare price references the price of generic drugs if available. Click the link under “Savings options” to see the latest drug prices.

How to get Restasis without insurance

Without help from an insurance company, brand-name prescription medication prices can seem intimidating—and Restasis is no exception. Fortunately, paying full price isn’t the only option. Manufacturer coupons, savings programs, and patient assistance programs sometimes provide drastic discounts, but not everyone is eligible. Here are some reliable ways to save money on Restasis eye drops:

1. Sign up for a SingleCare savings card

Enrolling in SingleCare is easy and free, and best of all, it can save hundreds on the price of Restasis and other prescription or over-the-counter drugs. With a SingleCare prescription discount card, you could pay as little as $163 for one month of generic Restasis instead of the usual $798 for the brand-name version. After enrolling, compare prices and coupons for various pharmacies, find the best one, present the SingleCare discount card to the pharmacist, and save.

2. Enroll in Medicaid

For some people, Medicaid may save money on doctor’s visits, tests, procedures, and prescription drugs—including Restasis. Medicaid eligibility is typically based on income level and other personal circumstances, although it varies by state. Visit your state’s Medicaid website or call the local health department.

3. Shop around

Each pharmacy sets its own medication rates, and some charge less than others. In some cases, much less. “Some pharmacies provide coupons, and your doctor’s office should have these available for you,” Dr. Rapoport says.

4. Ask about a generic version

Generic drugs are often less expensive than brand-name ones. Combining those savings with a prescription discount program like SingleCare can add savings. Generic cyclosporine received FDA approval in 2022. Ask your healthcare provider for additional information and medical advice before switching. 

5. Try a compounded version

The compounded version of cyclosporine is called Klarity-C, and it can be much cheaper than Restasis. Certain studies have found it safe and effective, but because it’s so new, there’s not much conclusive data yet.