Xiidra is lifitegrast 5% ophthalmic solution, a twice-daily prescription eye drop for dry eye disease. It came to market under Novartis and is now a Bausch + Lomb product, which is why you will still find both companies attached to it in the FDA’s drug listings.
For a cash payer, Xiidra is an unusual drug. There is no generic, so the usual “ask for the generic” advice does nothing. But the manufacturer publishes an actual fixed cash price for uninsured patients, which very few brand-name drugs do, and that price is roughly a quarter of what the same box costs at the pharmacy counter. Knowing that one number is worth more than any coupon hunt. Everything below was researched September 3, 2026.
What Does Xiidra Cost Without Insurance?
Four independent 2026 sources price this drug, and they spread wider than most because they are measuring different things. CMS’s National Average Drug Acquisition Cost survey, which measures what pharmacies actually pay wholesalers, listed Xiidra at $11.83110 per single-use container effective August 19, 2026. A standard carton holds 60 containers, so that is $709.87 in pharmacy acquisition cost for a 30-day supply. NADAC is not a retail price, and the pharmacy adds its own margin and dispensing fee on top.
Drugs.com quotes a cash price of $731.38 for 60 containers, or $12.19 each. SingleCare lists an average retail price of $1,017.08 for the same 60-container quantity, with a discount-card price of $726.37. And Bausch + Lomb’s own savings card terms state that patients without health insurance may pay a fixed cash price of $225 for a 30-day fill.
| Xiidra (lifitegrast 5%) cost item | Low | Typical | High |
|---|---|---|---|
| 30-day supply (60 containers), manufacturer cash price | $225.00 | $225.00 | $225.00 |
| 30-day supply (60 containers), retail | $709.87 | $731.38 | $1,017.08 |
| 90-day supply, manufacturer cash price | $675.00 | $675.00 | $675.00 |
| Per single-use container, pharmacy acquisition (CMS NADAC) | $11.83 | $11.83 | $11.83 |
| Average Medicare Part D gross spending per claim, 2024 | $1,058.62 | $1,058.62 | $1,058.62 |
| Commercial insurance with copay card | $0 | $0 | $0 |
The Medicare row is worth a second look. CMS’s Part D spending data shows average gross spending of $1,058.62 per Xiidra claim in 2024 across 166,361 beneficiaries and $505.3 million in total spending, which works out to $11.19 per dosage unit. That is within 6% of the NADAC figure, which tells you the acquisition cost is real rather than a number nobody transacts at.
What Drives the Price
There is no generic lifitegrast. The FDA’s drug product directory lists lifitegrast 5% ophthalmic solution only as Xiidra, under Bausch & Lomb Incorporated and the older Novartis listing. Compare that with cyclosporine eye drops, where eight or more companies now list a generic and the acquisition cost collapsed. Until a generic lifitegrast arrives, the brand sets the price.
Which price you are quoted depends on which door you walk through. The same carton is priced four different ways: what the pharmacy paid for it, what the register rings up, what a discount card knocks it down to, and what the manufacturer will accept directly from an uninsured patient. The spread between the highest and lowest of those is more than $790 a month.
Package size. Bausch + Lomb sells Xiidra in a 60-container carton (12 pouches of 5) and a smaller 20-container carton (4 pouches of 5). The 60-count box is the 30-day supply, since the label calls for one drop in each eye twice daily and a single container covers both eyes for one dose.
Insurance status, in a way that is unusually literal here. Bausch + Lomb’s terms create three separate buckets: commercially insured, “not covered” patients with commercial insurance whose plan blocks the drug, and patients with no insurance at all. Each bucket gets a different price. The $225 figure belongs specifically to the last one.
Age, oddly. The savings card terms say it is not valid for any person 65 or older without commercial insurance. An uninsured 66-year-old is excluded from the $225 price by the fine print, and has to go the patient-assistance route instead.
Cash Price vs. Insurance
If you have commercial insurance, the copay card is the obvious move. Bausch + Lomb says eligible commercially insured patients may pay as little as $0 on the first 90-day prescription and as little as $0 for each refill, subject to a maximum monthly benefit. If your plan covers the drug but you have a high deductible, expect to pay more than $0 until that deductible is met, which the terms say plainly.
If you have commercial insurance but the plan does not cover Xiidra, or it is blocked by prior authorization or a step edit, the same card still works for up to 12 fills per calendar year, no more than once every 24 days. That path uses Other Coverage Code 03 at the pharmacy, which is a detail worth mentioning to the pharmacist if the claim rejects.
If you have no insurance, you get the fixed cash price: $225 for 30 days, $450 for 60 days, $675 for 90 days. There is no discount for buying the 90-day quantity, so the arithmetic is simply $225 a month either way. Compared against the $710 to $1,017 retail range, that is a 68% to 78% discount, which is a bigger cut than any pharmacy discount card on this drug delivers.
If you are on Medicare, Medicaid, TRICARE or VA coverage, none of the above applies. The card is void for federal and state program beneficiaries. Xiidra.com says the drug had preferred coverage on several large Part D plans based on January 2026 data, so the practical question for a Medicare beneficiary is what your plan’s tier and deductible look like, not what the cash price is.
How to Pay Less
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Ask specifically for the manufacturer cash price, not a coupon. Pharmacy staff will often reach for a generic discount card first. The Bausch + Lomb program is a different thing, it is processed through the savings card at the counter, and it is the cheapest published route for an uninsured patient by a wide margin. Have the enrollment done before you drop off the prescription.
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Compare discount cards before you assume they help here. SingleCare’s card price on Xiidra sits near $726, which is barely below the ordinary cash price and more than three times the manufacturer’s $225. Our comparison of GoodRx vs. SingleCare explains when these cards genuinely win and when they do not, and this drug is a clear case where the manufacturer program beats them.
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If you are 65 or uninsured and shut out of the card, apply for patient assistance. Xiidra.com points patients with limited assets, limited prescription coverage or government insurance to the Bausch + Lomb Patient Assistance Program, which can supply the medication at no cost to people who qualify. It is an income-tested application, not an instant discount, so start it early.
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Do not let the eye exam blow the budget separately. You need a prescription, which means a visit. A self-pay eye exam has its own cash range worth checking, and a free or sliding-scale clinic can often handle the follow-up visits once you are established on treatment.
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Price the whole dry-eye shelf before you commit. Restasis and generic cyclosporine sit in a completely different price band because a generic exists, and Miebo has its own $225 uninsured price from the same manufacturer. Which one is right for you is a clinical question, but knowing that one of them has an $8-a-month generic version changes the conversation.
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Sanity-check any quote that looks off. Our fair price checker lets you compare what you were quoted against published figures, and if a bill has already gone sideways, our guide to negotiating medical bills covers the script.
Bottom Line
As of September 2026, an uninsured patient should be paying $225 a month for Xiidra, full stop. That is Bausch + Lomb’s own published cash price and it is available from the manufacturer’s savings program, not from a third-party coupon site.
Retail without that program runs $710 to $1,017 for the same 60-container carton, and the discount cards only bring it to roughly $726, which is not close. The two situations where the $225 does not apply are Medicare or Medicaid enrollment and being 65 or older without commercial insurance, and both of those route you to the Bausch + Lomb Patient Assistance Program instead. With no generic lifitegrast on the market, those are the only real levers there are.