BLOG: Multi-dose Restasis enters the fray

Whoops! How did I miss this one? Well, I didn’t actually miss it; I just forgot to make a big deal out of it around here. Allergan has a new product on the market in the dry eye space, and if you take care of DED patients, you probably should know about it.

It’s called Restasis.

No, seriously! There really is something new about Restasis (cyclosporine ophthalmic emulsion 0.05%), it’s certifiably cool, and it will matter to at least some of your DED patients. Allergan has patented and gotten the FDA to approve a bottle that provides multiple doses of sterile, non-preserved medications. No more unit-dose bullets. The new multi-dose Restasis bottle features a one-way opening and a filter that prevent reverse flow back into the bottle. This is meaningful to patients who have difficulty manipulating the single dose dropperettes. We already have a SkyVision patient with a prescription waiting to fill when the product hits the shelves.

Each bottle will have a bit of "over-fill," and Allergan is stating that it will charge the same price for a bottle as it does for a 1-month tray of traditional applicators. Let’s do a little math, shall we? Let's say the "over-fill" is 180 drops, a generous pour if you will. That would be a 45-day supply. A 1-month supply of traditional Restasis (Restasis Classic?) contains 60 bullets. You know ... one for both eyes in the morning and another for the evening. We all know that every single patient uses that first bullet for both doses that day (60 days in each tray), and most of them go the 24-hour route (three doses/bullet = 90 days/tray).

The FDA regulates the label, but it can’t regulate the patient.

Don’t kid yourself: The good folks at Allergan have done this math, too, so let’s give credit where credit is due. Allergan will continue to produce and sell Restasis in both delivery systems, classic and multi-dose. Restasis product manager Taryn Conway, her bosses and her team deserve a pat on the back for making the tough but proper call to put the interests of the DED patient before the bottom line.

I’m just sorry it took me a month to get around to saying so.

Disclosure: White reports he is a consultant for Bausch + Lomb, Allergan, Shire and Eyemaginations; is on the speakers board for Bausch + Lomb, Allergan and Shire; and has a financial interest in TearScience.

Editor's Note: This blog has been corrected from the original post to correct inaccuracies.