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Xiidra Patient assistance program

Is your Xiidra medication too expensive? Start receiving your medication for only $49 per month.*

Complete a free online enrollment application to find out if you’re eligible to pay only $49 per month for your Xiidra medication.

Get started today
  • Secure: Your personal and medical information is safe with us
  • Convenient: We manage the whole process and we’re here to assist you
  • Ongoing refills: We request your medication refills on your behalf
  • Secure: Your personal and medical information is safe with us
  • Convenient: We manage the whole process and we’re here to assist you
  • Ongoing refills: We request your medication refills on your behalf

NiceRx works with your healthcare provider to help you access affordable medications directly from U.S. pharmaceutical companies.

An introduction to NiceRx

Play video (01:52)
  • An introduction to NiceRx
    (01:52)
  • Next steps after qualifying
    (00:38)
  • Uploading documents and billing
    (00:50)
  • SSN & billing information
    (00:33)
  • Medication delivery time
    (00:41)

How it works

  • Apply Online

    Get started by filling out the online enrollment application to find out if you are eligible.

  • Qualification

    NiceRx verifies your eligibility for medication assistance and notifies you if you are qualified.

  • Upload Documents

    You may be required to submit further information and documents required by the pharmaceutical company which can be securely uploaded online.

  • Application Created

    Your application is created and sent to your doctor for signature. At this stage, you will be billed $49 and will not be billed again until you receive your first medication delivery.

  • Receive Medication

    Your application is sent to the pharmaceutical company. You will be billed again once you receive your medication. We handle the entire ordering process including requesting ongoing refills.

Your monthly Xiidra cost savings if eligible

Through the Xiidra patient assistance program, the only cost for your medication will be a monthly fee of $49. If eligible for Xiidra assistance, you could save:

Strength Avg. monthly price at
a US pharmacy
NiceRx monthly
price
Monthly savings
with NiceRx
5% 60 droperettes$560.00$49.00$511.00

Am I eligible for the Xiidra patient assistance program?

You will need to meet the eligibility criteria for Xiidra assistance. We will review each application individually, but the main factors that are considered by most programs include:

  • I am a permanent, legal resident of the United States or Puerto Rico
  • I am uninsured or my insurance doesn’t cover my medication
  • I meet certain income eligibility requirements

How do I apply for the Xiidra patient assistance program? 

Our process is simple and straightforward. NiceRx makes it as easy as possible to apply for the Xiidra patient assistance program. It begins with your online enrollment application. You will need to tell us about any medications you’re taking, including Xiidra. We’ll also ask for details about your healthcare provider, your insurance plan, and your household income. This information is required by the pharmaceutical manufacturers who ship your medication, meaning it must be accurate and up to date.

Once NiceRx determines that you may be eligible for Xiidra assistance, we’ll handle the full enrollment process for you. When enrolled in the Xiidra patient assistance program, we’ll also request your Xiidra medication refills on your behalf for up to one year.

Is NiceRx a Xiidra coupons provider?

NiceRx is not a Xiidra coupon, a Xiidra discount card, or a Xiidra copay card provider. We are a service provider that helps eligible individuals access the Xiidra patient assistance program. We don’t offer printable Xiidra manufacturer coupons, Xiidra discounts, rebates, Xiidra savings cards, trial offers, or free Xiidra samples.

You will likely save more through NiceRx, if you are looking for coupons for Xiidra or cheap Xiidra. When securing your Xiidra medication through NiceRx, your total cost for the medication will always be $49 per month.

Can NiceRx help me get Xiidra if I have insurance? 

At NiceRx, we may be able to help if you have insurance. This includes if you have a high copay or coinsurance responsibility or your insurance company won’t pay for your Xiidra medication. We may even be able to assist if you don’t have insurance. Apply online with NiceRx to find out more.

How much is Xiidra with insurance?

The price of Xiidra with insurance will vary by healthcare plan. Your pharmacist or healthcare provider will be able to calculate your copay with your current insurance.

How much does Xiidra cost without insurance?

Xiidra prices without insurance vary depending on the retailer you buy it from. As a guide, a pack of 60, 5% Xiidra single-use vials will cost around $730.

What is Xiidra?

Xiidra is a prescription eye-drop medication used to treat the symptoms of dry eye syndrome in adults. Xiidra comes in single-use vials that can be used to drop the liquid solution onto your eyes.

Dry eye syndrome, also called dry eye disease and keratoconjunctivitis sicca, is a condition where your eyes don’t produce enough liquid to clean and lubricate themselves. As well as dryness, your eyes can also feel irritated, redden, produce a discharge, become tired easily, and your vision may blur. Dry eye syndrome can be mild to severe, and can cause scarring in some cases.

If you have dry eye syndrome, your doctor may prescribe Xiidra to you. It’s an eye-drop medication that can reduce the inflammation and swelling in your eyes that can block and reduce your tear production.

Xiidra active ingredients

The active ingredient in Xiidra is called lifitegrast. It helps to reduce inflammation in your eyes. Inflammation is a natural process triggered by your immune system. It’s usually beneficial, as it helps your body kill harmful pathogens and recover from injury. However, inflammation in the wrong places and for too long can cause problems like dry eye syndrome.

Lifitegrast reduces inflammation by blocking a step in the process that triggers it. It prevents a molecule called LFA-1 joining with a molecule called ICAM-1, which usually stimulates inflammation. By blocking this step, it limits how much inflammation your immune system can cause in your eyes.

Xiidra side effects & Xiidra drug interactions

When Xiidra does cause side effects, the most common include:

  • Eye irritation
  • Eye discomfort
  • Blurred vision when the drops are applied
  • A condition called dysgeusia, a taste disorder that causes a foul, rancid, metallic, or salty taste

In rare instances, Xiidra can cause more serious side effects. Specifically, this includes severe allergic reactions that can cause wheezing, difficulty breathing, and a swollen tongue

In some instances Xiidra can interact with other medications, which can change how Xiidra and the other medications work and can make some side effects more likely. Tell your prescribing physician about all drugs you’re taking, including vitamins and dietary supplements.

Xiidra warnings & precautions

Xiidra isn’t suitable for everyone. Don’t take Xiidra if you:

  • Are allergic to the active ingredient lifitegrast
  • Are allergic to any of the other ingredients in Xiidra 
  • Are under 18 years of age

Talk to your doctor before taking Xiidra if you:

  • Are taking any other medications 
  • Use any other eye drops
  • Wear contact lenses
  • Are pregnant or are planning to become pregnant
  • Are breastfeeding or are planning to breastfeed

*Qualifying persons may obtain medications directly from patient assistance programs without any out-of-pocket cost (or for less than $49 per medication). However, our monthly flat rate of just $49 per medication spares you the hassle of tracking down the different programs and filling out all the required paperwork for each program.

Enrollees enjoy a full-service solution, as NiceRx assists them and their physicians with the entire process. We prepare all required documents for the physician to sign, help enrollees manage all prescription refills, monitor eligibility criteria, and maintain enrollment.

**If you do not receive medications because you were determined to be ineligible for the prescription assistance by the applicable pharmaceutical companies and you have a letter of denial, we will refund any fees you paid toward medications for which you did not qualify to receive prescription assistance (“Refund”).

To receive a refund, you must send the letter of denial to us by fax to 888-517-7444, or by e-mail to [email protected] within 30 days of your receipt of such letter. The Refund is your sole and exclusive remedy for any fees you may wish to dispute.