How to Help Your Patients Save Money on Besivance: A Provider's Guide to Savings Programs

Besivance (besifloxacin 0.6% ophthalmic suspension) is clinically valuable for bacterial conjunctivitis, but its brand-only status and retail price of $230–$350 per bottle create significant access barriers for patients. High out-of-pocket costs are a leading driver of prescription abandonment — particularly for a short-course medication treating an acute condition like pink eye, where patients may opt to "wait it out" rather than pay full price. This guide provides prescribers with a comprehensive overview of available savings programs and practical strategies to keep patients on their prescribed therapy.

Understanding the Cost Landscape for Besivance

The cost barriers for Besivance come from multiple directions:

No generic equivalent: With patents estimated through November 2030, no generic besifloxacin will reach the market for several years.

High retail price: $230–$350 per 5 mL bottle is significantly higher than generic alternatives ($15–$40 for generic moxifloxacin).

Insurance barriers: PA is required for ~30% of ACA and ~80% of Medicaid enrollees. Coverage is available for ~50% of Medicare beneficiaries.

Step therapy: Some plans require documented failure of a cheaper alternative before covering Besivance.

Program 1: Bausch + Lomb Access Program (Commercial Insurance)

The Bausch + Lomb Access Program is the most impactful savings tool for commercially insured patients:

Copay as low as $25 per prescription for commercially insured patients

Up to 6 fills per 12-month period

Available at: Walgreens and other participating pharmacies

Activation: blsavings.com, 1-866-693-4880, or text BLSAVINGS to 24109

Not eligible: Medicare, Medicaid, Tricare, VA

Clinical recommendation: Include the Access Program activation information in your after-visit summary or provide a printed card. Many patients are unaware of this program and will pay full retail price unnecessarily.

Program 2: Bausch and Lomb Patient Assistance Program (Uninsured/Underinsured)

For patients without insurance or with inadequate coverage, the Bausch and Lomb Patient Assistance Program may provide Besivance at no cost. Key details:

US citizen or legal resident required

Income thresholds apply (typically individuals <$40,000; couples <$60,000; large families <$100,000 annually)

Application requires valid prescription and proof of income

Processing time may be several days — not suitable for immediate acute need

Contact: 866-316-7263 or bauschaccessprogram.com

For patients with an acute bacterial conjunctivitis who cannot wait for PAP processing, bridging them to a generic alternative while the PAP application is pending is a practical approach.

Discount Cards: GoodRx and SingleCare

Prescription discount cards are a practical, immediate solution for patients paying out of pocket:

GoodRx: Reduces Besivance price to approximately $133–$226 at participating pharmacies. GoodRx Gold ($9.99/month) can bring it to ~$133.

SingleCare: Prices starting at approximately $204 at select pharmacies.

These cards are free to use, require no enrollment, and can be used whether or not the patient has insurance. Some patients may find GoodRx cheaper than their insurance copay even with coverage. Many practices now include GoodRx QR codes or SingleCare links in their patient handout materials.

Navigating Prior Authorization and Step Therapy

For plans that require prior authorization or step therapy, consider the following strategies:

Template letter of medical necessity: Prepare a standard LMN that explains the clinical advantages of besifloxacin: novel compound, dual-target mechanism, ophthalmic-only compound with preserved susceptibility profile, DuraSite delivery, broad-spectrum coverage.

Document step therapy failure: If a patient has had a prior treatment failure with generic ciprofloxacin or tobramycin, document this clearly in the chart for PA support.

Assign PA ownership: Designate a staff member to manage PA submissions for ophthalmic specialty medications. This prevents delays from falling through the cracks.

When to Prescribe an Alternative Instead

For patients on government insurance with high barriers and an uncomplicated presentation, prescribing generic moxifloxacin 0.5% or gatifloxacin 0.5% as first-line is often the most practical approach. Both offer comparable coverage for most community-acquired bacterial conjunctivitis and are widely available for $15–$40. Reserve Besivance for patients with a specific clinical rationale (prior treatment failure, known resistance concerns, or when you have strong reason to prefer the novel compound).

Quick Reference: Besivance Savings Programs for Providers

Bausch + Lomb Access Program: $25/Rx for commercially insured | blsavings.com | 1-866-693-4880

Patient Assistance Program: Uninsured/underinsured | 866-316-7263 | bauschaccessprogram.com

GoodRx: ~$133–$226 | goodrx.com | no enrollment required

SingleCare: ~$204 | singlecare.com | no enrollment required

The Bottom Line for Providers

Proactively communicating savings options at the point of prescribing can dramatically reduce abandonment and ensure patients complete their antibiotic course. Incorporating Access Program cards, GoodRx codes, and a referral to medfinder (for stock availability) into your workflow requires minimal staff effort but meaningfully improves outcomes. For more on patient access strategies, see our guide to helping patients find Besivance in stock.