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RESTASIS® COST

Cost Cost

HOW MUCH RESTASIS® COSTS

There are several ways to save on RESTASIS® treatment. Explore your options below.


Allergan® is committed to making your RESTASIS® treatment affordable and accessible. The RESTASIS® list price, also known as the wholesale acquisition cost (WAC),1 is $586 for a 30-day supply of RESTASIS® or RESTASIS MultiDose®. However, the amount you pay will largely depend on your health insurance coverage.

savings information

SEE YOUR COVERAGE FOR PRICING AND SAVINGS INFORMATION

HEALTH INSURANCE I PAY FOR OR GET THROUGH WORK

THE AVERAGE MONTHLY COPAY FOR RESTASIS® CAN VARY FROM PLAN TO PLAN

  • About 80% of patients pay less than $35 for a RESTASIS® or RESTASIS MultiDose® prescription.2 This cost includes use of RESTASIS® savings cards.

REASONS WHY YOUR MONTHLY COST MAY DIFFER3

  • A savings card was not used
  • The plan deductible hasn’t been met
  • Not all health insurance plans are the same, and they may have different rules and benefits

Restasis Savings Card

ELIGIBLE PATIENTS PAY AS LITTLE AS $0*

Sign up for a savings card through My Tears, My Rewards® and you may be able to pay as little as $0* for a 90-day supply of RESTASIS®.

Restasis Savings Card

MEDICARE

WITH MEDICARE PART D COVERAGE

  • Most patients who qualify for the Extra Help program pay between $0 and $9 per month.2
  • About 80% of those who don't qualify for Extra Help can expect to pay between $0 and $50 per month.2

To see if you qualify for the Extra Help program, click here Opens an external site in new tab.

REASONS WHY YOUR MONTHLY COST MAY DIFFER3

  • A lack of supplemental coverage (Part D)
  • The benefit varies during different coverage phases of most Part D plans
  • Not all Part D plans are the same, and they may have different rules and benefits

MEDICAID

About 90% of RESTASIS® prescriptions have an out-of-pocket cost between $0 and $4 per prescription.2

REASONS WHY YOUR MONTHLY COST MAY DIFFER3

  • Household income could play a role in determining your monthly cost
  • Out-of-pocket charges vary from state to state

Refer to your state agency for details about Medicaid out-of-pocket costs. Or visit Medicaid.gov Opens an external site in new tab.

NO INSURANCE

The Allergan® Patient Assistance Program provides certain products to patients in the United States who are unable to afford the cost of their medicine and who meet other eligibility requirements. The RESTASIS® list price is $586 per month, plus any additional pharmacy charges depending on where you purchase your medicine.

DOWNLOAD THE ALLERGAN® PATIENT ASSISTANCE PROGRAM APPLICATION

GENERAL INFORMATION

For more information on RESTASIS®, visit RESTASIS.com or call us at 1 (888) 412-0154 (option 5).

DOWNLOAD ALLERGAN®’S UNDERSTANDING HEALTH INSURANCE

List price is effective January 2, 2021 - December 31, 2021.

1The price at which Allergan® sells its products to wholesalers.

2Symphony Health®. Managed Markets Vantage™: January 2019 - December 2019.

3Contact your prescription coverage provider (commonly referred to as a pharmacy benefit manager) to learn more.

APPROVED USE

RESTASIS® and RESTASIS MultiDose® Ophthalmic Emulsion help increase your eyes’ natural ability to produce tears, which may be reduced by inflammation due to Chronic Dry Eye. RESTASIS® and RESTASIS MultiDose® did not increase tear production in patients using anti-inflammatory eye drops or tear duct plugs.

IMPORTANT SAFETY INFORMATION

Do not use RESTASIS® and RESTASIS MultiDose® Ophthalmic Emulsion if you are allergic to any of the ingredients. Be careful not to touch the container tip to your eye or other surfaces, to help avoid eye injury and contamination. RESTASIS® and RESTASIS MultiDose® should not be used while wearing contact lenses. If contact lenses are worn, they should be removed prior to use of RESTASIS® and RESTASIS MultiDose® and may be reinserted after 15 minutes.

The most common side effect is a temporary burning sensation. Other side effects include eye redness, discharge, watery eyes, eye pain, foreign body sensation, itching, stinging, and blurred vision.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit FDA Goverment WebsiteOpens an external site in new tab, or call 1-800-FDA-1088.

Click here for full Product Information for RESTASIS® Opens an external site in new tab and RESTASIS MultiDose® Opens an external site in new tab.

*Up to a $300 savings for a 90-day supply of RESTASIS® single-use vials or up to a $255 savings for a 30-day supply of RESTASIS® single-use vials. Up to a $300 savings for 3 bottles of RESTASIS MultiDose® or up to a $250 savings for 1 bottle of RESTASIS MultiDose®. Patients who are enrolled in Medicare, Medicaid, or any similar federal or state healthcare program are not eligible for savings or rebates according to federal and state law. Offer applies only to prescriptions filled before the program expires on 12/31/21.

The actual savings on your out-of-pocket costs for RESTASIS MultiDose® and RESTASIS® will vary according to refill quantity and personal healthcare insurance coverage. Please review the My Tears, My Rewards® Program guidelines to learn more.

APPROVED USE

RESTASIS® and RESTASIS MultiDose® Ophthalmic Emulsion help increase your eyes’ natural ability to produce tears, which may be reduced by inflammation due to Chronic Dry Eye. RESTASIS® and RESTASIS MultiDose® did not increase tear production in patients using anti-inflammatory eye drops or tear duct plugs.

IMPORTANT SAFETY INFORMATION

Do not use RESTASIS® and RESTASIS MultiDose® Ophthalmic Emulsion if you are allergic to any of the ingredients. Be careful not to touch the container tip to your eye or other surfaces, to help avoid eye injury and contamination. RESTASIS® and RESTASIS MultiDose® should not be used while wearing contact lenses. If contact lenses are worn, they should be removed prior to use of RESTASIS® and RESTASIS MultiDose® and may be reinserted after 15 minutes.

The most common side effect is a temporary burning sensation. Other side effects include eye redness, discharge, watery eyes, eye pain, foreign body sensation, itching, stinging, and blurred vision.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit FDA Goverment WebsiteOpens an external site in new tab, or call 1-800-FDA-1088.

Click here for full Product Information for RESTASIS® Opens an external site in new tab and RESTASIS MultiDose ® Opens an external site in new tab.

*Up to a $300 savings for a 90-day supply of RESTASIS® single-use vials or up to a $255 savings for a 30-day supply of RESTASIS® single-use vials. Up to a $300 savings for 3 bottles of RESTASIS MultiDose® or up to a $250 savings for 1 bottle of RESTASIS MultiDose®. Patients who are enrolled in Medicare, Medicaid, or any similar federal or state healthcare program are not eligible for savings or rebates according to federal and state law. Offer applies only to prescriptions filled before the program expires on 12/31/21.

The actual savings on your out-of-pocket costs for RESTASIS MultiDose® and RESTASIS® will vary according to refill quantity and personal healthcare insurance coverage. Please review the My Tears, My Rewards® Program guidelines to learn more.