Medically reviewed by, Russell Braun RPH
Have you suffered from dry eyes nearly your entire life? Has a doctor every told you that you have a disease called dry eye disease? Even worse, have you been trying to treat your ongoing dry eyes with over the counter medications on your own?
The agony of eyes that feel like they have sand in them can be hard to bear. Do dry eyes decrease your enjoyment of life? If so, it is time to do something about it. Good news, Restasis can help. Then you find out how expensive it can be!
It makes you wonder, is there a Restasis coupon?
What is Restasis?
Restasis (cyclosporin) 0.05% is an eye preparation available in multi dose and single dose vials. It is used to treat chronic dry eyes and dry eyes associated with inflammation.
The drops are used twice a day and over time may help your eyes naturally produce tears. This helps keep the eyes moist and prevents the symptoms of dry eye.
How does Restasis work?
Cyclosporin the active ingredient in Restasis, suppresses immune system reactions, which are thought to cause chronic dry eyes. The exact component of the immune system Restasis suppresses is unknown.
It is important to have a general idea how the drug works when you compare it to other drugs for dry eyes. Over the counter options typically do not work in this same way.
Restasis is available by prescription only and should only be used under the direction of your doctor and pharmacist.
Learn more about how to deal with dry eyes without drugs in this great resource written by Dr. Robert Latkany.
Are there coupons for Restasis?
Most brand name drugs will have a copay coupon savings card available. The coupon will take the copay (or deductible amount owed per prescription) from whatever your insurance sets it at, and reduce it down to a specific amount set by the manufacturer. An example would be the copay is $150 for brand drugs but the Restasis coupon pays $145 of that cost leaving the patient with a small copay of $5.
On the surface the Restasis copay coupon savings card sounds great, pay just a few dollars per month. However, beware of a few very important details that could cost you big bucks in the long run.
1. The higher your income, the higher the amount you will have to pay for each copay. Consequently, not everyone will get the lowest copay of $5.
2. Restasis copay coupon savings card has a maximum amount it will pay. The maximum amount is $300 for 90 days and $255 for 30 days supply. Typically a yearly max will apply as well, but is not provided publicly. Therefore asking the manufacturer before using is critical.
3. Copay coupon savings DO NOT apply toward deductibles.
4. All patients who are covered by government insurance are ineligible. Therefore, Medicare, Medicaid, Tricare and any other government insurance are ineligible.
5. Uninsured patients are also not eligible, you can only use the Restasis coupon WITH insurance.
6. Restasis coupon can’t be combined with other discounts or coupons.
7. Only participating pharmacies will accept the Restasis coupon.
How Drug copay coupon card programs work
It is important to understand why Allergan Pharmaceuticals, the manufacturers of Restasis offers a copay coupon. Here is a quick breakdown on why copay coupons, also called savings cards even exist.
To understand more on drug copay coupon cards click here.
Steps to take before using a Restasis coupon
#1 Is there a generic drug for Restasis?
Today Restasis is brand name drug only. The generic, cyclosporine ophthalmic can’t be manufactured and sold until the patents expire for Restasis. Lawyers working for Allergan have been finding new ways to protect the patent. Consequently, Restasis will not be generically available until 2024.
#2 Are there therapeutic alternatives to Restasis?
A therapeutic alternative is a drug that had different chemical contents, but has the same effects as other drugs for treating a condition. Restasis has no generic alternative, but does have some therapeutic alternatives. Some of these therapeutic alternatives have generics which also means they will be substantially cheaper. Before trying a Restasis coupon make sure to try one or more of the generic alternatives listed in table 1 and 2 below.
Some of the therapeutic alternatives to Restasis that are prescription only and also don’t have generics. Make sure to ask your doctor about the options that have lower cost generics available.
|Brand name||Generic name||Sold generically?|
|FML / Flarex||Fluorometholone||Yes|
Over the counter
Some of these over the counter options are available in both over the counter and prescription strengths. The good news, they all have generic versions available! Again, talk to your doctor about the dose and frequency for which to take these medications based on symptoms. Sometimes using more than one medication that work in different ways in the body can provide relief. Ask your doctor if that is something you should try.
Some people with dry eyes have problems with medications that contain preservatives. On the list below, Soothe is the only drop that doesn’t contain preservatives. Again discuss this with your doctor and see what may be best for you.
|Brand name||Generic Name|
|Artificial tears||Carboxymethyl cellulose and polyvinyl alcohol|
|Refresh tears||Carboxymethyl cellulose|
|Systane||Propylene glycol and polyethylene glycol|
Finally, keep in mind that Restasis or other medications may not alleviate their symptoms on their own. Restasis can be used at the same time as artificial tears. Ask your doctor before combining medications like this, but know it could prove quite useful.
# 3 Utilize drug discount programs to research alternatives
Drug discount programs are available today in a variety of formats. It is imporant to understand the differences in a drug discount card or app in contrast to the Restasis coupon. These discount programs negotiate prices with one or all of the following:
- Pharmacy benefit managers (PBM’s)
- Drug manufacturers
Most work with pharmacies who want to show up in the search function on the discount programs website or mobile application. Therefore, patients can see a discounted price the pharmacy negotiates with the discount program. Keep in mind these can not be used with insurance, but instead when the negotiated price is better than the price with insurance. Most people would not think the discount price could be better than insurance, but many times it is. A few of the major discount programs available today include:
Restasis has a high list price and because of that drug discount programs are not going to make the price tag manageable for most people. The best practice is to use drug discount programs to see how much the alternatives to Restasis (listed in table 2 above) cost and talk to your doctor about those options.
#4 How much does Restasis cost without insurance?
For example, how much does Restasis cost at Walmart?
Using a the drug discount website GoodRx, you find that a bottle of Restasis that would last 30 days costs $619 at Walmart!
Typically, Restasis is around $600 – $650 depending on where you live. That price is the cash price, without any insurance using a drug discount program discount.
As you can see even with the discounted price, that cost each month can add up quickly.
Again, checking to see if the therapeutic alternatives that have generics are cheaper without insurance is a good idea. Many times your insurance copay might be more than what you can buy them for from the pharmacy paying cash.
#5 Is Restasis covered by insurance?
What can be done if a therapeutic alternative is not an option? Check with your insurance to see if Restasis is on formulary. If indeed it is on formulary it will have a more favorable out of pocket cost for you.
Check with your pharmacist to calculate your out of pocket cost using your insurance. Costs can vary widely depending on your insurance plan.
Also, the type of insurance plan you have will make a big difference.
- High deductible health plans (HDHP) will have a large deductible that will come from your pocket or the Restasis coupon.
- Preferred provider organizations (PPO) will have a set copay amount, Restasis coupon can also be used for that copay.
HDHP vs. PPO explains more on the differences between these types of insurance.
#6 Is Restasis covered by Medicare?
Restasis ranges from being covered as a preferred drug all the way to being not covered by Medicare. The only way to know for sure in your situation is to go to Medicare.gov and use the plan compare tool. Follow the prompts and provide your basic information about prescriptions and pharmacy preference. Next, you will see many details about coverage, focus in on two things:
- Drug deductible
- Pharmacies & prescription drugs
Clicking on the link under pharmacies & prescription drugs will show you exactly how much Restasis will cost you monthly and yearly.
Remember, Restasis copay coupon can NOT be used for Medicare!
Medicare also offers the Extra Help subsidy, for lower income people. Everyone on Medicare should check to see if they are eligible, because investigating costs you nothing. Consequently, if you are eligible the savings could be huge.
#7 Are there samples available?
Before trying any new medication the best practice is to try samples. Brand name drugs like Restasis will have samples that the manufacturer provides to doctors. Sampling the medication allows a trial where it can be determined if the medication is going to be well tolerated or not. For the best outcome I recommend bullet journaling medication effects.
Restasis like other medications for dry eyes can take a few days to a week to determine if it is working. Ask for enough samples to last at least two weeks. This provides enough time to determine effectiveness, side effects and allows time to get a prescription filled.
#8 Patient Assistance Programs (PAPs)
In addition to offering the Restasis coupon, a patient assistance program is available through the Allergan Patient Assistance Program. The program is designed to help patients get Restasis at low or no cost.
Can I get Restasis for free?
Many patients who receive funding through a PAP may get medication for free. You have to check with Allergan as this is determined on a case by case basis.
To be eligible for this assistance patients must meet the following criteria:
- Be a citizen of the United States or legal entrant
- Those with insurance can contact program to determine if eligible
- Medicare Part D eligible if you were denied for the low income subsidy
- Have a medically appropriate diagnosis
- Income limit based on Federal Poverty Level (FPL)
Anyone who is close to the FPL cutoff level should still apply. The applications are approved on a case by case basis and anyone slightly over that mark could still get assistance.
The Allergan Patient Assistance Program form for Restasis can be downloaded here. A doctor must complete the paperwork sign and return to Allergan. The optimal time to complete the process is right after the doctor provides you with samples. The delivery of the medication is typically within 10 days. That should ensure the assistance is available when you need to get a prescription filled.
State Prescription Assistance Programs (SPAPs)
Some states have there own state pharmaceutical assistance programs that are run by the state. They normally focus on low-income patients and also offer some type of Medicare Part D coverage as the Restasis PAP may not apply to Medicare enrollees.
A state by state listing of SPAPs can be searched on Medicare.gov.
#9 How do I get a Restasis copay coupon savings card?
After trying the steps mentioned above, the Restasis coupon may be the best option because it does lower copay or deductible costs. Once you confirm that Restasis worked and was well tolerated, a coupon can be obtained here.
Allergan claims that patients can get Restasis for as low as $5 dollars for a 30 or 90 day supply using the Restasis coupon.
Please remember the Restasis coupon has a maximum payout and is only good for 12 fills of a 30 day prescription or 4 fills of a 90 day supply.
Finally, you may be able eligible to get a new savings coupon the next year that is good for another 12 fills or the maximum payout amount.
Beware of copay accumulator programs!
Many insurance companies have added a feature called a copay accumulator, because high deducible health plans are becoming more common. This is a fancy term for counting how much of the deductible (or copay) was paid by the patient versus the copay coupon. When accumulators are used any amount paid by the copay coupon will NOT count toward the deductible.
For more information on these programs and an example that makes it easy to understand read my pharmacist tips on copay accumulator programs.
Click here to get Dr. Jason Reed’s exclusive list of medication questions you MUST ask your doctor, for FREE!
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