Which is cheaper, Restasis or Xiidra? A Complete Cost Comparison

October 7, 2025 •

5 min read

Chronic dry eye disease affects millions, with prescription eye drops often a necessary long-term treatment. When comparing prescription options like Restasis and Xiidra, the cost can be a deciding factor for many patients. A significant consideration is that Restasis has a generic version available, while Xiidra does not, which dramatically impacts the final price.

Quick Summary

A comparison of Restasis and Xiidra for chronic dry eye finds Restasis is generally cheaper, especially with a generic version available. Final costs depend on insurance, copay cards, and patient assistance, but Restasis offers more affordable options. Key differences also include speed of relief and side effects.

Key Points

Generic vs. Brand Name: Generic cyclosporine, the equivalent of Restasis, is significantly cheaper than brand-name Xiidra, which has no generic option.
Out-of-Pocket Costs: Cash prices for generic Restasis are typically much lower than brand-name Xiidra, especially when using discount cards.
Insurance and Medicare Coverage: Restasis and its generic are often covered by insurance, including Medicare Part D, while Xiidra coverage can be more variable and may require prior authorization.
Savings Programs: Manufacturer savings cards and patient assistance programs can reduce or eliminate copayments for commercially insured and eligible uninsured patients for both medications.
Response Time: Xiidra may provide faster symptom relief than Restasis, but Restasis is still a reliable long-term treatment.
Side Effects: Xiidra is often associated with an unusual taste sensation, while Restasis may cause a burning or stinging feeling upon application.
Personalized Decision: The most affordable option depends on your specific insurance plan and clinical needs, requiring a conversation with your eye doctor.

The choice between prescription dry eye medications like Restasis (cyclosporine) and Xiidra (lifitegrast) is complex, involving not just clinical effectiveness but also cost and insurance coverage. For most patients, the most straightforward answer to the question, 'Which is cheaper, Restasis or Xiidra?' is Restasis, primarily because it has a widely available, lower-cost generic version. However, the full picture depends on your specific insurance plan, eligibility for savings programs, and how quickly you need symptom relief. Understanding the details of each medication's cost is key to making an informed decision with your healthcare provider.

Generic vs. Brand Name: The Most Significant Cost Factor

The availability of a generic alternative is the single most important factor driving the cost difference between Restasis and Xiidra. Generic drugs are typically much more affordable than their brand-name counterparts, and this is especially true in this case.

Restasis (Cyclosporine Ophthalmic Emulsion)

Restasis was the first FDA-approved prescription eye drop to increase tear production by addressing inflammation. While the brand-name version can be expensive, a generic version of cyclosporine ophthalmic emulsion is widely available in the United States. With discount cards like GoodRx, a 30-day supply of generic cyclosporine can be found for under $100, a fraction of the cost of brand-name Restasis or Xiidra. For long-term chronic conditions, this price difference can lead to substantial savings over time.

Xiidra (Lifitegrast Ophthalmic Solution)

Unlike Restasis, Xiidra currently has no generic equivalent. This means patients must purchase the brand-name product, which comes at a significantly higher retail price. The lack of a generic option removes the most reliable and consistent path to cost savings for patients.

Out-of-Pocket Costs Without Insurance

For uninsured patients, or those with high deductibles, the difference in cash price is stark:

Brand-name Restasis: A 30-day supply of brand-name Restasis can have an average cash price of several hundred dollars without insurance.
Generic Cyclosporine: The equivalent generic version can be purchased for significantly less using a discount coupon. Mark Cuban's Cost Plus Drugs, for instance, offers generic cyclosporine for around $62 plus fees for a box of 30 vials.
Xiidra: The average retail price for a 30-day supply of Xiidra (60 single-use vials) can exceed $700 without insurance. Using a coupon can lower this, but it generally remains much higher than generic cyclosporine.

The Impact of Insurance Coverage (Commercial and Medicare)

For patients with health insurance, the out-of-pocket cost is dictated by their plan's formulary, copay, and deductible. It's crucial to check your specific plan details.

Commercial Insurance: Both medications may be covered, but Restasis (and its generic) often falls into a more favorable tier, leading to a lower copay. A recent report from March 2025 indicated that Xiidra has strong coverage across many commercial plans, but eligibility for $0 copay programs is limited to commercially insured patients and can be complex. Prior authorization is a common hurdle for both medications.
Medicare: Coverage for prescription eye drops like Restasis and Xiidra falls under Medicare Part D. Restasis and its generic are frequently covered, though cost depends on the plan. Xiidra has historically had less consistent Medicare coverage than Restasis, but this can vary by plan. Medicare enrollees are generally ineligible for the manufacturers' copay programs designed for commercially insured patients.

Manufacturer Savings Cards and Patient Assistance Programs

Several programs exist to help reduce the cost, especially for those without adequate coverage.

Restasis Savings Card: Eligible commercially insured patients can use a savings card from the manufacturer (AbbVie) to potentially pay as little as $0 for their prescription.
myAbbVie Assist: The manufacturer also offers a patient assistance program for uninsured or underinsured patients who meet income requirements.
Xiidra My Savings Program: Bausch + Lomb offers a savings card for eligible commercially insured patients that can bring the copay down to as little as $0.
Bausch Access Program: This program may offer medication at a set, reduced price for those without commercial insurance coverage for Xiidra.
Third-Party Coupons: Websites like GoodRx and SingleCare offer coupons that can lower the cash price for both brand and generic medications.

Comparison Table: Restasis vs. Xiidra Cost Breakdown


Feature	Generic Cyclosporine (Restasis)	Brand-name Restasis	Brand-name Xiidra
Generic Available	Yes	No (Brand only)	No (Brand only)
Typical Cash Price	~$60-$200+ (with coupon)	~$400-$800+	~$700-$860+
Insurance Coverage	Common for most plans	Common for many plans	Variable, may require pre-authorization
Medicare Coverage	Often covered (Part D)	Often covered (Part D)	Variable, can be limited (Part D)
Savings Card	N/A (for generic)	Eligible commercial patients may pay $0	Eligible commercial patients may pay $0
Patient Assistance	Yes (myAbbVie Assist)	Yes (myAbbVie Assist)	Yes (Bausch + Lomb program)
Side Effects	Burning, stinging	Burning, stinging	Unusual taste, irritation

Beyond the Price Tag: Efficacy, Side Effects, and Speed

While cost is important, effectiveness and tolerability are equally critical. Xiidra may offer symptom relief quicker than Restasis, with some patients reporting improvement within two weeks, whereas Restasis can take up to three months to show significant results. Both medications are effective and target the underlying inflammation of dry eye disease, but they work through different mechanisms. Xiidra is a lymphocyte function-associated antigen-1 (LFA-1) antagonist, while Restasis is a calcineurin inhibitor. Patients often find one medication more effective or tolerable than the other, regardless of cost.

Conclusion: How to Determine Your Most Affordable Option

For most individuals, generic cyclosporine (the generic equivalent of Restasis) is the most budget-friendly choice for treating chronic dry eye, especially for those without comprehensive insurance or with high deductibles. However, the final answer to which is cheaper, Restasis or Xiidra, is highly personalized.

To find your most affordable option, consider these steps:

Check with your insurance provider. Confirm if brand-name Restasis, generic cyclosporine, and brand-name Xiidra are covered and what the copay is for each.
Look for savings programs. If you have commercial insurance, check if you are eligible for the manufacturer savings cards for Restasis or Xiidra to reduce your copay.
Use a coupon app or card. If you are paying cash, use a service like GoodRx or SingleCare to find the best available price for generic cyclosporine at local pharmacies.
Consider Patient Assistance. If you are uninsured or underinsured, investigate patient assistance programs offered by the manufacturers.

Ultimately, a discussion with your ophthalmologist or optometrist is the best way to weigh the clinical factors against the cost, and select the medication that provides the best long-term value for your specific needs.

Authoritative Outbound Link: American Academy of Ophthalmology - Dry Eye

Frequently Asked Questions

No, Xiidra is currently only available as a brand-name medication (lifitegrast ophthalmic solution). The absence of a generic alternative is a key reason for its higher cost compared to Restasis.

No, manufacturer savings cards for both Restasis and Xiidra are typically only valid for commercially insured patients and explicitly exclude use by those with government insurance like Medicare, Medicaid, or TRICARE.

To find the lowest cost for generic cyclosporine, you can use prescription discount cards from services like GoodRx or SingleCare. By checking prices at various local pharmacies, you can secure significant savings over the retail price.

While Xiidra's retail price is higher, for eligible commercially insured patients who can utilize a manufacturer's savings card, their out-of-pocket cost could be as low as $0, potentially making it cheaper than Restasis's copay. However, without such a program, Xiidra is almost always more expensive.

Insurance coverage varies significantly. Many commercial and Medicare Part D plans cover Restasis (and its generic), while Xiidra's coverage can be more variable. Your final out-of-pocket cost depends on your plan's specific formulary, and both often require prior authorization.

Patient assistance programs, like myAbbVie Assist for Restasis and the Bausch + Lomb program for Xiidra, are available for eligible uninsured or underinsured patients. These programs can provide medication at no cost to those who meet specific income and insurance criteria.

The best approach is to speak with your ophthalmologist and pharmacist. Your doctor can help you weigh clinical factors, and your pharmacist can provide the most accurate cost estimates based on your insurance plan and any applicable discount coupons or savings cards.