“This is not to say the drug doesn’t work (although not in every case, and it can burn); it is beneficial to many patients when tear drops alone are insufficient. I say give patients a choice, but don’t simply pass the buck to Medicare Part D or the insurance company. Let patients decide how they want to spend their money, and whether $100 to $200 per month is worth the benefit derived from this drug.”

Message: Spend YOUR money as you wish, but nobody has died from dry eye yet to the best of my knowledge, and I am very familiar with this disorder. I am simply arguing that the cost is high in an era of scarce healthcare dollars.

Did you ever wonder why this drug is not available without a prescription? If it were you would have access to it without even having to go to the doctor, but then the buck wouldn’t be passed and patients would have to decide for themselves if it is worth it.

If restasis is the only perscription drug available for dry eye of course most patients will want to try it and hope for the best. Its the paitents choice and if one doctor refused it they will just get it from another doctor.

Allergan promotes dry eye as a progressive disease which should be aggressively treated to prevent progression. You would think this condition must blind millions of people every year, rather than being a largely benign nuisance relative to other medical disorders competing for limited dollars. Allergan will tell you to prescribe this drug when patients are using artificial tears more than twice daily, and tell you that you are saving your patient money because Restasis is covered by insurance whereas artificial tears are not. Only the naive would ignore the fact that somebody IS paying for this liquid gold and that that money is passed through in higher patient insurance premiums and decreased reimbursements to providers.

I have a background in economics and will admit that it is difficult for a thinking person to prescribe this drug when you consider you are increasing health care expenditures by $1200 to $2400 per year per patient, depending on whether they use a fresh vial for each administration. This is not to say the drug doesn’t work (although not in every case, and it can burn); it is beneficial to many patients when tear drops alone are insufficient. I say give patients a choice, but don’t simply pass the buck to Medicare Part D or the insurance company. Let patients decide how they want to spend their money, and whether $100 to $200 per month is worth the benefit derived from this drug.

The shame of it is that some academics I used to respect have joined the Restasis roadshow as their barkers-for-hire.