How much does 8 weeks of oxervate cost?: Unpacking the high price of neurotrophic keratitis treatment

October 9, 2025 •

4 min read

Treatment with Oxervate, the first FDA-approved eye drop for neurotrophic keratitis (NK), can carry a list price estimated at over $118,000 for a full 8-week course. This substantial cost highlights the significant financial considerations for patients needing this specialized medication.

Quick Summary

An 8-week course of Oxervate has a list price that can exceed $118,000, though costs for patients vary drastically based on insurance coverage and the manufacturer's patient assistance programs.

Key Points

High List Price: A full 8-week course of Oxervate has an estimated list price that can exceed $118,000, reflecting the high cost of developing a novel treatment for a rare disease.
Insurance is Key: Health insurance is critical, as it covers a significant portion of the cost, with the ultimate patient out-of-pocket expense depending on the plan.
Manufacturer Financial Assistance: The Dompé CONNECT to Care Copay Program can reduce out-of-pocket costs for commercially insured patients to as low as $100.
Support for Uninsured: For uninsured patients, prescription coupon programs can offer significant price reductions, though the overall cost remains high.
Specialty Pharmacy Services: Oxervate is distributed by a specialty pharmacy and shipped directly to the patient's home, with manufacturer support coordinating the process.
Prior Authorization is Required: Due to its high cost, Oxervate requires prior authorization from insurance, a process that the manufacturer’s support program can assist with.
Alternative Considerations: Alternative treatments for neurotrophic keratitis exist, but they are not directly comparable and involve different costs and procedures.
Proactive Engagement: The best strategy for managing Oxervate's cost is to work closely with your healthcare provider and actively engage with the manufacturer's patient support programs.

Oxervate (cenegermin-bkbj) is a specialized ophthalmic solution used to treat moderate to severe neurotrophic keratitis (NK), a rare degenerative disease affecting the cornea. As the only FDA-approved medication of its kind, its pricing reflects the high cost of research and development for an orphan drug. The manufacturer, Dompé, has established a support system to help patients manage the medication's significant cost. Understanding the various factors affecting the final price is crucial for anyone considering or undergoing this treatment.

The significant list price for an 8-week course

For many patients, the initial sticker shock of the Oxervate list price is considerable. A full 8-week treatment involves administering one drop of the solution six times a day. A single vial of Oxervate contains a week's worth of doses for one eye and can carry a high list price. Early estimates in 2021 cited a list price of $1,732 per vial, leading to a total course cost of approximately $96,992, based on 56 vials needed over 8 weeks. More recent figures from 2024 and 2025 have placed the estimated full 8-week cost even higher, around $118,230. These figures represent the potential cost to an insurance company or a patient without any form of financial assistance, but they do not necessarily reflect what an individual will pay out-of-pocket.

Cost scenarios: Insurance coverage vs. uninsured

The final cost of Oxervate depends heavily on a patient's insurance status, plan, and participation in patient support programs.

The role of health insurance

For commercially insured patients, the out-of-pocket cost can be managed through manufacturer-sponsored programs. For instance, the Dompé CONNECT to Care Copay Program can reduce an eligible patient's out-of-pocket costs to as little as $100 for the full 8-week course. However, the cost to the insurance provider remains substantial, with one ophthalmologist citing a cost of around $11,000 per week to the insurance company. For Medicare patients, costs can fluctuate significantly based on the coverage stage, including deductible, initial coverage, and the 'donut hole' (coverage gap). Navigating these phases can lead to vastly different costs for the same course of treatment.

Navigating the uninsured cost

Patients without insurance face the full, unmitigated cost, which can be over $118,000. However, even uninsured individuals can seek out savings through various discount programs. Prescription coupon services like GoodRx and Blink Health can provide significant discounts, bringing the price down substantially, though it remains a formidable expense. For example, GoodRx reported coupon prices for Oxervate in 2025 that were significantly lower than the average retail price.

The prior authorization process

For all types of insurance coverage, prior authorization is almost always required for Oxervate due to its high cost and specialized nature. This can be a rigorous process, but manufacturer support programs are designed to assist healthcare providers and patients with this complex administrative hurdle. Without a successful prior authorization, insurance will likely refuse to cover the treatment.

Patient assistance and support programs

Recognizing the financial burden of Oxervate, its manufacturer, Dompé, offers the comprehensive Dompé CONNECT to Care program. This program is a critical resource for patients, providing assistance with multiple aspects of the treatment journey.

Key services provided by Dompé CONNECT to Care include:

Insurance verification: Helps confirm coverage details with the patient's insurance provider.
Financial assistance: Offers programs, such as the copay program, to reduce out-of-pocket expenses for commercially insured patients.
Prior authorization support: Assists the doctor's office in navigating and completing the prior authorization process.
Specialty pharmacy coordination: Facilitates the biweekly shipment of Oxervate from a specialty pharmacy like Accredo directly to the patient's home.

Comparison of Oxervate cost and alternative treatments

For neurotrophic keratitis, alternative treatments do exist, but their effectiveness can vary depending on the disease stage. Some of these are surgical interventions or other non-drug options. A direct cost comparison in the United States is complex due to different pricing models, but here is a simplified view based on available data.


Treatment Option	Estimated U.S. Cost (Without Assistance)	Potential Patient Cost (With Assistance)	Notes
Oxervate (Cenegermin)	$118,230 (list price for 8 weeks)	As low as $100 for eligible commercially insured patients	Biweekly home delivery via specialty pharmacy
Amniotic Membrane Graft (AMT)	Cost varies significantly by procedure and facility	Depends on insurance coverage and procedure complexity	Surgical intervention, not a medication
Surgical Tarsorrhaphy	Cost varies by procedure; Canadian data is ~$778 CAD	Depends on insurance coverage; may be permanent	Surgical procedure to partially close the eyelid

Note: Costs for surgical alternatives are highly variable based on location, provider, and insurance. The Canadian figure for tarsorrhaphy from an NCBI source is for illustrative comparison only.

Conclusion: Navigating the path forward for patients

The cost of an 8-week course of Oxervate is high, but the list price does not tell the whole story. Due to the manufacturer's robust patient support and assistance programs, many patients with commercial insurance may find their out-of-pocket expenses to be manageable. The process is complex, involving specialty pharmacies and rigorous prior authorization, but the Dompé CONNECT to Care program is designed to guide patients and providers through it. For those without insurance, discounts are available through third-party services, though the total cost remains very high. Therefore, communication with your healthcare provider and proactive engagement with the manufacturer's support program are the most effective strategies for patients seeking this treatment.

For more detailed information on neurotrophic keratitis and its treatment, including clinical trial data, a resource from the National Institutes of Health (NIH) provides extensive context.

Frequently Asked Questions

Without insurance, the list price for a full 8-week course of Oxervate can exceed $118,000. However, uninsured patients can explore significant savings through prescription coupon programs, with some services listing prices in the tens of thousands of dollars.

Yes, many health insurance plans cover Oxervate, but it typically requires prior authorization. For commercially insured patients, the manufacturer offers a copay program that can reduce out-of-pocket expenses to $100 for eligible individuals. Coverage and costs for Medicare patients can vary significantly based on their coverage stage.

Dompé CONNECT to Care is a patient support program offered by the manufacturer of Oxervate. It assists patients with insurance verification, prior authorization, financial assistance options, and coordination of medication delivery via a specialty pharmacy.

Oxervate's high price is attributed to several factors. It is an orphan drug for a rare condition (neurotrophic keratitis), which means research and development costs are spread over a very small patient population. Additionally, as a novel, first-in-class treatment, it lacks direct competition.

Direct cost comparisons are difficult. While Oxervate is a medication, alternatives like surgical tarsorrhaphy or amniotic membrane grafts (AMT) are procedures with variable costs. The final cost for alternatives depends heavily on insurance coverage, facility, and procedural complexity.

The most effective way to reduce the cost is to work with your healthcare provider and enroll in the manufacturer's Dompé CONNECT to Care program. This program assists with prior authorization and financial aid, potentially bringing costs down to as little as $100 for eligible, commercially insured patients.

Medicare prescription drug plans (Part D) may cover Oxervate, but the patient's out-of-pocket cost will vary depending on the plan's specific stages (e.g., deductible, coverage gap). Costs can range from standard copays to significantly higher amounts while in the coverage gap.

To begin, your doctor must prescribe Oxervate and submit an enrollment form to the Dompé CONNECT to Care program. The program will then contact you to discuss insurance, financial options, and delivery from the specialty pharmacy.