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Why Is Xiidra So Expensive?

Key Takeaways

  • Xiidra (lifitegrast ophthalmic solution) is a brand-name prescription eye drop used to treat dry eye disease, and brand-name drugs are generally more expensive due to research, development, and marketing costs.
  • There is no generic version of Xiidra available yet in the U.S., which keeps prices significantly higher than many dry eye treatments, such as Restasis, Cequa, or over-the-counter artificial tears.
  • The cost of Xiidra varies widely depending on your health insurance plan, Medicare, Medicaid, and whether your insurer’s formulary.
  • Manufacturer savings programs, savings cards, and patient assistance programs may reduce out-of-pocket costs for eligible patients.
  • The retail price of a month’s supply or 90-day supply can be high and will vary depending on which pharmacy you use.

What Is Xiidra?

Xiidra is an FDA-approved prescription drug used twice daily for the treatment of dry eye disease. Its active ingredient, lifitegrast ophthalmic solution, works differently from lubricating drops or artificial tears by targeting inflammation, the underlying cause of many symptoms of dry eye disease.

Xiidra is often prescribed for people with:

  • Chronic dry eye.
  • Symptoms like burning, stinging, blurred vision, or eye irritation.
  • Insufficient relief from OTC lubricant eye drops.

Why Is Xiidra So Expensive?

The price of Xiidra eye drops can vary from person to person. It can depend on several factors, including your insurance coverage and the pharmacy you use. Some of the major reasons Xiidra costs so much include:

It’s still a brand-name medication with no generic competition

As of now, there is no FDA-approved generic version of Xiidra. Without generics, the manufacturer sets the retail price, which tends to remain high due to:

  • Research and development costs
  • Clinical trial expenses
  • Marketing and distribution
  • Patent protection

Generic drugs dramatically reduce costs once available, but until then, brand-name medications remain significantly more expensive.

Xiidra treats inflammation and not just dryness

Unlike artificial tears, which simply lubricate the eye, Xiidra targets the inflammatory process behind dry eye disease. This more complex mechanism contributes to its higher price, similar to other prescription therapies like Restasis and Cequa.

Because of its unique formulation, production costs for Xiidra may be higher than typical OTC eye drops.

Insurance coverage varies widely

Your insurance coverage plays a major role in determining how much Xiidra will cost.

Factors include:

  • Whether your insurance provider includes Xiidra on its formulary
  • Whether the insurer requires prior authorization
  • Your deductible
  • Whether Xiidra is preferred over Restasis or Cequa
  • Copay amounts and tier placement

Some plans cover Xiidra with a reasonable copay, while others classify it as a high-tier medication with significant out-of-pocket costs.

Medicare

Medicare Part D plans may cover Xiidra, but costs depend on:

  • The plan’s formulary
  • Whether you are in the deductible phase
  • Your pharmacy choice

Medicaid

Coverage varies by state. Some Medicaid programs require step therapy, meaning you may have to try lower-cost dry eye treatments first.

The retail price is significantly higher than OTC alternatives

A month’s supply of Xiidra can be expensive without insurance. Prices often vary based on:

  • Pharmacy location
  • Whether you purchase a 90-day supply through mail-order
  • The pharmacy’s negotiated rates

Because Xiidra comes in single-use vials, packaging costs are also higher compared to multi-dose OTC bottles.

Does Insurance Help Lower the Cost of Xiidra?

Yes, private and commercial insurance plans often help reduce costs, but the amount varies.

Some factors that determine your cost through insurance include:

  • A standard copay
  • A percentage-based cost after your deductible
  • Tier-based pricing
  • Prior authorization requirements

Some insurance companies may also prefer other drugs first, such as:

  • Restasis
  • Cequa

In some cases, your doctor will need to provide documentation that Xiidra is medically necessary before your insurance will cover it.

Savings Programs and Financial Assistance

Xiidra Savings Card

Commercially insured patients may qualify for a Xiidra savings card, significantly lowering copays. Visit Xiidra’s website for more information about any savings cards available.

Patient Assistance Programs (PAPs)

These programs are designed for people who:

  • Do not have insurance.
  • Have high out-of-pocket costs.
  • Have insufficient coverage under their plan.

Eligibility varies, and applications often require income information. Visit Xiidra’s website for more information about any PAPs available.

Mail-order and Pharmacy Shopping

Some patients save money by:

  • Using mail-order pharmacies.
  • Asking about 90-day supply discounts.
  • Comparing prices across major pharmacy chains or online pharmacies like UDS.

Side Effects and Why They Matter to Coverage

While many patients tolerate Xiidra well, side effects can include:

  • Temporary burning or eye irritation
  • Strange or metallic taste
  • Redness
  • Blurred vision

Insurers sometimes assess the side effects of Xiidra, clinical effectiveness, and alternatives when determining formulary placement and coverage.

How to Reduce the Cost of Xiidra

  • Review your insurance plan’s formulary
  • Apply for manufacturer savings programs
  • Ask your pharmacy about a mail-order option
  • Consider switching to Restasis or Cequa if medically appropriate and if your plan prefers them instead
  • Use OTC lubricants as supportive therapy

Bottom Line

Xiidra is expensive because it is a brand-name, FDA-approved prescription medication with no generic competition, specialized anti-inflammatory action, and high manufacturing and development costs. Its final price depends heavily on your insurance coverage, whether your insurer requires prior authorization, and whether you can access savings programs or financial assistance.

If cost is a barrier, speak with a healthcare professional about alternative treatments, switching medications, or accessing assistance programs.

FAQs

Is there a generic version of Xiidra?
No. As of now, no FDA-approved generic version exists. There are alternative treatments available that may be right for you. Talk with your provider if Xiidra is too expensive.

Why is my copay so high?
It depends on your insurance plan, tier placement, and deductible.

Does Medicare cover Xiidra?
Many Medicare Part D plans do, but out-of-pocket costs can vary.

Are there cheaper options for dry eye?
Yes, including Restasis, Cequa, and artificial tears. Ask your provider which fits your treatment plan.

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