Forced from Restasis to Xiidra

[LadyDi]

Hi, I was wondering if anybody else has been forced by insurance to switch from Restasis to Xiidra prescription drops. I went to the pharmacy today to pick up my Restasis and they gave me the news.

I put in a call to my ophthalmologist and they said that they are seeing this happen more frequently now. She said to try the Xiidra for three weeks and if I don't have the same relief that I have had with Restasis, then she will fight for me with the insurance company.

Has anybody here had any success with Xiidra? They have different mechanisms of action, which is why I am afraid that it won't work for me. I feel like this will then set me back, where Restasis has been working for me for a number of years.

I am a firm believer in, "If it ain't broke, then don't try to fix it." Why on earth do the insurance companies have to do this to us? The pharmacist told me that they were both the same price too!  I really have not been feeling too well of late to deal with this! I pay a decent premium for this insurance, which I get through my employer. Anyone?

[irish]

My DIL who is an optometrist says that the price on the xilldra will most likely be going up in the future once the newness wears off so it will either catch up with the Restasis or end up costing more. It makes me think that some middle man somewhere is making some extra money off this while they can.

Yes, I agree, if it aint' broke don't fix it. Irish

[Pete0211]

I was just given a prescription for Xiidra, but given the newness of the drug, I'm not keen on taking it until it's been on the market a few years.

Clinical trials of Xiidra show significant effect after 42 days - so three weeks might not be enough to evaluate it properly, and that's three weeks not on Restasis, which I understand has several months before significant effect. Given this, I would ask the doc to use the "don't fix what ain't broke" argument plus the length of time necessary for Restasis to become effective, which would cause you undue discomfort over a stupid move by the insurance agency.

[Tharrell]

It's working for me, I like it better than restasis as it burns a lot less and calms down the inflammation in my eyes.  My ophthalmologist, who heads th sjogren's clinic at Baylor, recommended it to me back in September.

[Sooki]

From what I understand, the two drugs do different things.  They should not be interchangeable by insurance companies!  And you can take them together to get the benefits of both.  That's a nasty situation that's unfolding.   

I think Xiidra is being very proactive about getting insurance companies on board.  When they first introduced it, they gave that big discount for a year to get patient demand up.  They must have been working with insurance companies as well.  Restasis needs to push back!

[ariel]

I have been using Restasis for 4 years and it is not working for me. My doctor switched me to Xiidra and I have been using it for a month. It burns still but I can say that my light sensitivity has improved. I am going to give it a 3 month trial and see what happens. Restasis is supposed to help with tear production whereas Xiidra is supposed to treat dry eye disease. Both Restasis and Xiidra cost the same with my insurance and Restasis is on the formulary whereas Xiidra is not. This is my understanding of the two.

[irish]

This is really a no win situation for many people. If one has been on the Restasis for a long time and it is working(this is me) then probably ha Tve no desire to change. The drug salesmen are hanging around the optometrists offices according to my DIL and these people are the ones making some money.

Now, be patient with this as it just occurred to me that the cost ratio may not be a good test. The Xiidra costs so much per box for how many ampules and is used how many times a day?

The Restasis comes in a box of so many (30 maybe, I can't remember) and it can last for 2 months. The optometrists of my state many years ago worked with this and decided that we could open the ampule and use it for 2 days. Each day we put a drop in each eye morning and evening. The eye doc can give you these little blue plastic ampule holders that will stand up in a plastic storage box with a cover. The idea is to keep the tip of the ampule clean to prevent eye infection. Also, you canli keep the container in the refrig as some people like the drops cold especially when just starting the drops. The coolness helps decrease the burning.

So, if the Xiidra can't be used more than once and saved for the next day also then the Restasis may be cheaper. You will have to be the one to make that decision. Irish

[Tharrell]

I think the Xiidra makers got smart and they know that there is enough restasis in an ampule to use multiple times eventhough the box clearly states not to save the left overs. I did that as well considering the cost of restasis. Xiidra is making the ampule smaller, so there really is no leftovers after one time use. You have to use a new ampule per application. In my box I have actually found empty sealed ampules, because they put so little in there that the factory machines miss filling some..
For me the restasis with insurance is $50 versus $30 on Xiidra.

[Pete0211]

My insurance has a deductible this year for all but Tier 1 drugs. Unfortunately (or luckily), my cevimeline is Tier 2, so I had to pay the deductible the first month ($264 total, plus the new plan started in Dec, so I had to pay $264 then, too due to different years). I had to get approval for Xiidra, and they are treating as a tier 3, so that will be $80/mo, minus whatever additional savings I get from Shire with the member card thingy (that expires this May).

[irish]

I just refilled by Restasis and it cost me 40$ for one box. Sooo, I can get 2 months out of one box so that is 20$ a month so that isn't so bad. I am Medicare with a supplement. Irish

[LadyDi]

Well, its been just about 2 weeks and Xiidra drops have made my eyes worse! I honestly feel as if they have compromised my vision and OMG they don't create any moisture whatsoever.

I plan on calling my eye doc tomorrow, because she said that she would fight for me with the insurance company to get them to allow me back on Restasis

Ugh...what a setback, as I had been doing so well for years on Restasis. If these insurance companies even had half a brain, they would know that Restasis and Xiidra are completely different and should NOT be interchangeable.

I'm pretty frustrated, as I feel that this has caused me quite a setback. My eyes are sore, red and feel like they are full of sand!

Thanks for listening

[katie1111]

I stand my open ampule of Restasis in a shot glass in the refrigerator.  I have been doing this for several years and it works well.

Katie1111

[LadyDi]

I am grateful that my ophthalmologist's office is contacting my insurance company to petition that Restasis is a necessary medication for treating my Sjogrens dry eyes.

I don't know what they thought that they were doing by substituting an eyedrop such as Xiidra, which has a completely different mechanism of action than Restasis does.

I feel that the only thing that they have accomplished, is setting me back for months with my eye health, where I had been successfully using Restasis for years.

Insurance companies make me so mad...they must have been receiving a kickback from the pharmaceutical company who makes Xiidra!!!!

[SunshineDaydream]

I am grateful that my ophthalmologist's office is contacting my insurance company to petition that Restasis is a necessary medication for treating my Sjogrens dry eyes.

I don't know what they thought that they were doing by substituting an eyedrop such as Xiidra, which has a completely different mechanism of action than Restasis does.

I feel that the only thing that they have accomplished, is setting me back for months with my eye health, where I had been successfully using Restasis for years.

Insurance companies make me so mad...they must have been receiving a kickback from the pharmaceutical company who makes Xiidra!!!!

Yup, that was my first though. Incentive from Big Pharma. I hope your doctor is able to get your Restasis prescription approved, and soon!

[LadyDi]

I am happy to report that my insurance company has restored my prescription for Restasis, because my ophthalmologist petitioned  that it was a medical necessity.

I have been using Xiidra for a month and one of the side effects is sinusitis. Well my nostils have been clogged for as long as I have been using it and now it maybe time for me to start with some antibiotics.

Darn these insurance companies...being off of Restasis has really set me back and negatively affected my overall health.