RESTASIS® COST
AND SAVINGS


The amount you pay for RESTASIS® can depend on a number of factors, including your access to prescription drug coverage, the type of insurance you have, and even the level of coverage your insurance may provide.
This page provides information that can help you determine how much RESTASIS® may cost for you, as well as financial support programs that may be able ta help you afford your medication.

RESTASIS® LIST PRICE
The RESTASIS® list price, also known as the wholesale acquisition cost (WAC),1 iS $645.63† for a 30-day supply of RESTASIS® or RESTASIS MultiDose®.
Call 1.844.4MY-TEARS (1-844-469-8327) to find how much RESTASIS® will cost for you.

SEE YOUR COVERAGE FOR PRICING
AND SAVINGS INFORMATION
THE AVERAGE MONTHLY COPAY FOR RESTASIS® CAN VARY FROM PLAN TO PLAN
- Average monthly patient cost with commercial insurance (including savings card): $53.27. In 2021, 80% of commercial patients paid $50 or less for RESTASIS® or Restasis MultiDose® 2.
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
WITH MEDICARE PART D COVERAGE
- 94% of patients who qualify for the Extra Help program pay $10 or less.2
- 62% of patients who don't qualify for Extra Help pay $50 or less.2
To see if you qualify for the Extra Help program, click here .
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
The average cost of RESTASIS® prescriptions have an out-of-pocket cost of $10.02.2
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 .
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®and RESTASIS MultiDose® list price is $645.63† per month, plus any additional pharmacy charges depending on where you purchase your medicine.


INSURANCE
COVERAGE SUPPORT
To help you understand your coverage and what your out-of-pocket costs may be, its important to verify your benefits.
And even if your RESTASIS® isn't covered, there may be way to save on your prescription. An Insurance Specialist can talk you through your coverage and help identify potential savings options - regardless of your insurance coverage.
For insurance questions or to verify your benefits, call 1-844-4MY-TEARS (1-844-469-8327)

SAVINGS PROGRAM
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®.
*Maximum savings limits apply; patient out-of-pocket expense will vary depending on insurance coverage. Offer valid for patients with commercial prescription insurance coverage and a valid prescription for RESTASIS® or RESTASIS MultiDose®. Offer not valid for patients enrolled in Medicare, Medicaid, or any other federal, state, or government-funded healthcare program. See My Tears, My Rewards® Savings Program Terms, Conditions, and Eligibility Criteria at bottom of page.

MYABBVIE ASSIST
If you are having difficulty paying for your medicine myAbbVie may be able to help.
myAbbVie Assist, out patient assistance program, provides AbbVie medicine to qualifying patients. It is intended for people that live in the United States, have limited or no health insurance coverage and demonstrate qualifying financial need.
Visit AbbVie.com/myAbbVieAssist to learn more.

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

†List price is effective January 14 2022
Analy$ource (Selected from FDB MedKnowledge (formerly known as NDDF Plus) data included with permission and copyrighted by
First Databank, Inc.)
1The price at which Allergan® sells its products to wholesalers.
2SHA Payersource Claims January 2021 - November 2021
3Contact your prescription coverage provider (commonly referred to as a pharmacy benefit manager) to learn more.
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.
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
www.fda.gov/medwatch FDA Goverment Website, or call
1-800-FDA-1088.
Click here for full Product Information for
RESTASIS® and
RESTASIS MultiDose®
.
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
www.fda.gov/medwatch FDA Goverment Website, or call
1-800-FDA-1088.
Click here for full Product Information for
RESTASIS® and
RESTASIS MultiDose ®
.