The Glaucoma Research Foundation (GRF) reports that many people with glaucoma have seen an uptick in recent years on prescription eye drop restrictions. Why is this happening and what can you do about it? What if you don’t have insurance coverage and can’t afford glaucoma medications?*

Tighter rules

Insurance companies are now limiting the amount of glaucoma eye drop medication patients can obtain and how often they can refill their prescriptions.

Of course, there’s a reason why patients can run out of eye drops ahead of schedule. It’s natural to occasionally miss the target and have the eye drop hit the cheek, or to squeeze out two drops at a time, says GRF.

To combat these stricter rules and ensure that people with glaucoma have access to sight-saving medication, the American Glaucoma Society and the American Academy of Ophthalmology have been meeting with officials from insurance companies and Medicare.

From these efforts, Medicare has instructed insurers to permit eye drop refills at reasonable intervals. 

What to do upon denial

If you’ve been denied the glaucoma medication you need or timely prescription refills, GRF has some suggestions.

• Monitor eye drop use. See how long each prescription lasts and talk to your pharmacist about the issue. They should know what’s allowed by your insurance.
• Register a complaint. If your pharmacist can’t get an exception for you to obtain more eye drops, file a complaint with your insurer or prescription drug plan using the customer service number on your card. 
  • Medicare supplemental plan or Part D drug plan recipients can call 1-800 633-4227 to complain about their plan’s eye drop refill rules.
• Speak to your eye doctor. Bring your insurance and prescription cards with you. Inform your doctor of any times you run out of eye drops before month’s end and if you ever have to skip doses because of it. Your doctor may be able to give you an eye drop sample to bridge the gap and request an exception with your insurer so you have enough medication.

Medication assistance programs

Besides other financial assistance, people with glaucoma who cannot afford medication should be aware of available manufacturer programs.

• Alcon Patient Affordability Programs for medications Rhopressa®, Rocklatan®, and Simbrinza®. Call 1-800-757-9195 (Mon-Fri 8am-5pm CST).
• Allergan, an AbbVie company, Patient Assistance Program for medications Alphagan® P, DurystaTM, and Lumigan®. Call (800) 553-6783.
• Bausch + Lomb U.S. Assistance Programs for medications Istalol, OptiPranolol®, Pilocarpine HCl, Timoptic®, and Vyzulta®. Call (855) 770-0424 (8 am-5 pm EST).
• Merck Patient Assistance Program for medications Cosopt®, Timoptic®, Timoptic XE®, and Trusopt®. Call (800) 727-5400 / Alt: (800) 994-2111 (9 am-7 pm EST).
• Novartis Patient Assistance Foundation, Inc. for medications Azopt®, Betoptic® S., and Travatan Z®. Call 1-800-277-2254.
• Pfizer RxPathways for XalatanTM. Call 1-866-706-2400.

In most cases, program participation will be through your eye doctor’s office. Inform your eye doctor that you cannot afford your needed medications and don’t have prescription coverage.

*Mattox, C. (2022, May 19). Problems with Prescription Eye Drop Refills? Glaucoma Research Foundation. https://glaucoma.org/problems-with-prescription-eye-drop-refills