I’ve been prescribed a dry eye drug.

Now what?

MyDryEyeRx offers information, insights and community wisdom about trying dry eye drugs.

My copay is too high.

Troubleshooting insurance coverage for dry eye drugs

Find out WHY the cost is so high.

Sticker shock is a common complaint in the dry eye patient community, regardless of insurance type. Among other reasons, most dry eye drugs are new and have no generics.

If you have been quoted an impossibly high price for a dry eye drug, don’t give up too quickly. It may not be your “real” copay. See the whole picture.

Six insurance factors that determine what you pay at the pharmacy

Insurance plans vary greatly. The information above focuses on policies and practices that are common to most insurers, and may not account for every possibility. Please contact your insurer for details.

Is your copay too high?

Check items 1-6 for issues that you can address.

The table above can help you determine where you stand in relation to your “best case” copay and what it might take to get there. Is step therapy required before the prescribed drug will be covered? Have you met your deductible? Or could you call the pharmacist or insurer to troubleshoot a failed prior authorization?

Unfortunately, for some individuals, either the drug isn’t covered at all, or the “best case” copay is not affordable. If that describes your situation, keep reading.

Is your copay still too high?

Check for manufacturer support.

Drug manufacturers offer programs that include:

  • copay cards (sorry, not available for Medicare patients)

  • cashpay prices and “buydowns” (often available for the first fill only, however)

  • income-based patient assistance programs

Is your copay still too high?

Talk to your eye care provider about alternatives.

If you have determined that you cannot pay your share of the dry eye drug that your provider has prescribed, it’s time to go back and discuss other treatment options. This might mean considering other dry eye drugs or other treatment types, both of which may require some more homework on your part about insurance coverage.

If the main reason your provider prescribed a dry eye drug was for symptomatic relief rather than clinical concerns, you can also look to self-care options and perhaps do a deeper dive to find more effective over-the-counter treatments. See the Self Care section and Product Guide in the Dry Eye Zone Patient Guidebook.

Do you have exceptional circumstances? (And plenty of motivation?)

Fight for better coverage, change plans, or change insurers

Exceptions and appeals

If your eye care provider believes you should be using a specific drug, yet despite best efforts the copay is too high, you can request policy exceptions from your insurer, such as. a tier exception or a step therapy exception. If your doctor’s prior authorization request was refused, or your exception request was refused, you can appeal. All these things take doctor time, which is at a premium, so you may need to be the one taking the initiative and even finding resources to make the process more efficient for your provider. Contact your insurer about the requirements. Some drug manufacturers have helpful forms that can save your doctor time.

Is it time to consider a new plan or new insurer?

If this is your first experience with a disease that requires new and costly drugs for ongoing treatment, this may be a new need that does not align with your current insurance. Some dry eye patients do change their plan or their insurer in order to improve their access to needed treatments.

The importance of self-advocacy

You are your own best advocate.

Make the investment to understand your insurance policy. It’s the most important first step towards ensuring you get the best possible coverage for your dry eye drug(s).

Work your way through the six questions above, and contact people on the following list when you have questions.

People who can help

I‘m not insured.

Navigating dry eye drugs without prescription drug coverage

Ideas & tips if you are uninsured

I haven’t started my Rx yet because….

Navigating information gaps and worries

Common hesitations:

What’s a fair trial?

Goals, yardsticks, mindset and support

Six steps for trying a new dry eye drug

Following these suggestions can help you feel more confident about the process and the decisions that lie ahead.

I’ve started… Now I have new questions.

Troubleshooting the first days and weeks

What if…

Is it helping? Should I continue?

Navigating complex decisions thoughtfully

Insights from community experiences

  • Setting the bar too high

    Are you looking at every new treatment as a potential “fix”, then deciding “it doesn’t work” if it fails to completely turn things around for you? Sometimes improvement is incremental. Sometimes it is a specific combination of treatments and lifestyle adaptations that get us to our goals. Sometimes we need to modify our goals.

  • Setting the bar too low

    Some of us are on a nonstop treatment merry-go-round. We continue to start new treatments. Anything that does not cause us new side effects gets added to our routine, even if it is not producing measurable benefits. We may need to set a higher bar for continuing a treatment.

  • Giving up too soon

    For some treatments, it is normal for improvement to not be immediate. If your symptoms fluctuate a lot (often the case), small improvements can be hard to detect. Patience and consistency may be very important factors in your success. Partnering well with our doctors and getting personal support can help us reshape expectations of quick relief.

  • Fear of starting

    Have your expectations hit rock bottom? Some of us get so beaten down by persistent symptoms and unsuccessful past treatments that we are afraid to try again. We may fear the letdown factor so much that we no longer try anything new. Remember to consider the possibility that a treatment may be unexpectedly helpful. It happens!

  • Hanging on too long

    People who have been through an exceptionally difficult (and maybe dark) period of uncontrolled symptoms often feel painfully vulnerable to the possibility of ‘relapse’. They may resist stopping a treatment even if there is no evidence that it helps them. Developing a ‘toolkit’ of non-medical symptom management strategies can help reduce this anxiety.

  • The multiple treatments trap

    Starting multiple treatments at the same time - no matter what type of treatments - can make it difficult to determine what is helping. Rather than adding yet another treatment, consider increasing your non-medical symptom relief strategies (such as moisture chamber glasses) till you have completed a full trial period on one treatment.

  • "Binary thinking"

    Have you mentally divided all treatments into two piles - the ones that work and the ones that don’t? The reality is often more nuanced. You may benefit from thinking in terms of whether a treatment will get you 50% closer to your goal, for example.

  • The Facebook group effect

    Social media groups are important to the patient community for connection, support and information. But they can also be echo chambers that create grossly exaggerated impressions for or against particular treatments. Seeing these treatments discussed over and over may create unconscious bias for or against a treatment.

  • Fear of "chronic" disease

    Many people with dry eye disease, depending on their causes and specific diagnoses, may be struggling with the possibility that they have a chronic disease. Wrestling with complex “acceptance” questions may, for a time, interfere with making good medical decisions. As time goes on, you will find it easier to navigate these decisions..

  • That was then, this is now

    Perhaps you have inadvertently dismissed a treatment or even an entire category of treatments based on a single past experience. But timing matters, and context and details matter. Don’t rule out the possibility that your eyes may react differently to a treatment now than they did in the past. Even a drug you once thought “doesn’t work” might have potential in your future.

  • Confounding factors and confusion

    Maybe you are trying a new treatment, or maybe an existing treatment that has worked consistently till now suddenly stops. Remember to step back and look at the big picture. What else might be affecting your eyes? Check pages 24-25 of the Dry Eye Zone Patient Guidebook for ideas about additional puzzle pieces. Keep your PCP and other health care providers in the loop too.

  • The trust factor

    Some of us have been through a lot and seen many providers while continuing to worsen. This can erode our capacity to trust, to settle with a provider and to partner effectively with them on any new treatment. We may need to get back to the basics of building a good relationship with a provider so that they will be better able to help us navigate new treatments.

  • Bias, placebo effect and nocebo effect

    Many things can bias us for or against a treatment. These biases can literally cause us to experience improvement or worsening of symptoms as a result of unconscious beliefs and expectations. The placebo effect can be a good thing - if we feel better, we feel better! On the other hand, persistent negative associations that have a nocebo effect might cause us to miss out on potential treatment benefits.

My Dry Eye Rx: Dry Eye Happy Hour Webinar

Streamed November 11, 2025 with Kaleb Abbott OD, Joseph Allen OD, Laura Periman MD. Moderated by Rebecca Petris.

Thank you, Viatris!

All content on this page was developed by Dry Eye Foundation.

Viatris, Inc. provided a charitable contribution to DEF to enable us to pursue this project. They were not involved in content development. We are truly grateful for their partnership.