Hi All,
I've recently switched jobs and I now have a high deductible plan. Being on Restasis, this is a bummer as many of you know I am sure! I was just wondering if anyone has heard any news on a generic form of Restasis?
I've been taking Restasis since October and it has helped my eyes so much. It is preventing the damage from dry eye, which was a major concern for my ophthalmologist and me. It is the first topical eye treatment that has worked for me and I would really hate to have to give it up due to cost. Under my current coverage, I would have to pay over $1,000 for a 90 day supply. That is WITH the Restasis card.
It's a shame that the pharma companies cannot lower these drug costs just a little so that it is affordable to people on high deductible plans, especially since these types of plans are gaining popularity among employers. I'm hoping someone finds a loophole with patent info somewhere, or the FDA steps in and allows for a generic (I don't know if either of these scenarios are possible but a girl can dream!)
Patiently waiting for a generic,
Shelly
I have not heard of a generic, but I have found a cheaper source (note, not cheap but cheaper). Please email me. Also remember, if you are careful you can use each little vial several times and that helps with the cost.
Katie
I am of the opinion (my humble opinion) that you should call the manufacturer of Restasis and tell them what you have to pay and ask if they have a way to get free or reduction.
I think the pharmacy and their distributor should be reported to someone for prices gouging. That is absolutely ridiculous to be charged that much. I have been on this drug since 2004 and have never seen or heard of a price that high. I got a years supply at one time not too long ago(pharmacist misunderstood the order-I had the money and paid for it cause it was not so bad per month) and paid under 500$ for one years supply.
The other thing is I am wondering if you are using your Restasis for two days. You can get 2 times a day for 2 days out of one of the ampules. I have been doing this for years as asvised by my optometrist. The Minnesota board of Optometry approved this this quite a few years ago.
I was advised to place the ampule in a covered container (plastic) abd don't touch the tip. Itt is advised to place the container in the refrig also. I do not put mine in the refrig and in 9 years have never had an eye infection. The eye doctor (or possibly pharmacy) should have a little blue stand to set the Restasis ampule so that it stands upright and doesn't touch anything with the tip. I just place this in the plastic container. I put a little wad of Kleenex in the container also so the stand and Restasis doesn't slide around.
This cuts your Restasis cost in half for the year. Good luck. Irish
I can totally empathize with you. Restasis has been amazing for my eyes, but the cost is steep. It seems to be keeping my recurring episcleritis under control for now. I have a super crappy insurance plan with a high combined drug coverage. My Plaquenil alone is $240-267 per month. Restasis cost me $340 for a one month supply (60 vials) this is at CVS which I assume is unlikely to gouge much. I keep mine in the fridge in a small plastic container and avoid touching tip to the eye (opthamologist's suggestion). I get 2 1/2-3 days out of each vial. The cold feels good too.
Like was mentioned.There are assistance programs for the drug but you have to go to the manufacturers website or do a search for financial assistance for Restasis. If you don't ask you won't get...
I think some insurance companies and some pharmacies are price gouging on the Restasis.
The amount I pay out of pocket for a 3 month supply of Restasis is $90. My insurance company pays either $390 or $842. (Towards the end of the year, Medicare Coverage Gap Discount Program pays the difference between the $842 and the $390.)
The point is, the combined total of the 90 day supply of Restasis for both the insurance company and me is $932. Yet, your insurance company/pharmacy is charging $1000 for a 90 day supply, and that is with the Restasis card. So you are paying more out of pocket for your Restasis than the total cost to me and my insurance company combined. The same is true for BKreader. So, basically, the insurance company is paying nothing for your Restasis. You are paying the full cost.
I agree with Irish that calling the manufacturer might be a good idea.
I also agree with Irish that the pharmacy and maybe the insurance company should be reported.
I get a breakdown every month of what my insurance company pays to the pharmacy for the drugs and what I pay to the pharmacy for the drugs. That way you know who is doing the price gouging.
Another thing you could do is to call the pharmacies, anonymously, and ask what the Restasis would cost out of pocket if you had no insurance. It would be interesting to know what that charge would be. Then call your insurance company and ask them how much they are paying for the Restasis. Your co-pay should not be higher than the difference. Plus, some insurance companies have contracts in place so that you pay a limited amount regardless.
Hi all,
Thank you for the great advice! I definitely live by the saying 'you're your best advocate' and with that notion, agree that I should contact the manufacturer regarding this issue. In the mean time, I am reading up on the patent info for Restasis and better educating myself on types of patents in general. It looks as though a generic form of Restasis will not be able to be made until 2024 - yikes!
Restasis originally had one patent that was supposed to expire May of 2014, which would have allowed for a generic form to be made, however in January of 2014 two more patents were approved for the drug and one of the new patents is a special patent that would allow no generic form until 10 years down the road (2024). I am not an expert in this field but it does look to be the case unfortunately.
On a *possibly* more positive note, Allergan, the maker of Restasis, was just bought out by Actavis, a pharma company that specializes in making generics so maybe there is some hope? I am not holding my breath.
I will start working on contacting the manufacturer. It might take a little while to reach the right person, but I will keep you all posted on my progress. By the time I'm done, hopefully there won't be a dry eye in the room ;) :)
Shelly- let us know what you find out.
Jasper- unfortunately, my insurance offers no discount or coverage of name brand drugs until I reach my $5000 deductible. Even after that, it is minimal help on the name brands. I just need better insurance. It's tough being self employed in California. My options are limited. I intend to call the manufacturer tomorrow as I am almost due for a refill.
BK ..... Okay, that makes sense. You are, indeed, paying full price for the Restasis (at least until you get to the $5,000 deductible). I hope you can get some help through the manufacturer.
Shelly and BK.....
There is a foundation called Patient Access Network Foundation which does help with medication costs. There are some qualification, but it might be worth looking into. One or both of you may qualify for assistance. Restasis is on the list of drugs that they will assist with. Hydroxychloroquin is also on the list of drugs they will assist with.
https://www.panfoundation.org/fundingapplication/whoqualify.php