Cost Is an Adherence Barrier for Prolensa

You've performed a successful cataract extraction. Your patient has a clear surgical plan, including Prolensa (Bromfenac 0.07%) for postoperative inflammation. Then they get to the pharmacy and discover the cash price: $250–$450 for a single bottle.

For many patients, this is where adherence breaks down. They skip the medication, use it less frequently than prescribed, or abandon the prescription entirely — all of which can compromise surgical outcomes.

As prescribers, we can directly impact adherence by building cost awareness into the prescribing workflow. This guide covers the savings programs, alternatives, and strategies available to help your patients afford their post-cataract NSAID regimen.

What Patients Are Paying

A quick overview of current Prolensa pricing:

• Brand-name Prolensa: $250–$450 per bottle (1.6 mL or 3 mL)
• Generic Bromfenac 0.07%: $80–$200 per bottle
• Generic Ketorolac ophthalmic: $15–$50 per bottle (but requires QID dosing)
• Generic Diclofenac ophthalmic: $20–$60 per bottle (QID dosing)

Insurance coverage for Prolensa is inconsistent. Many commercial plans and Medicare Part D formularies require prior authorization and/or step therapy — typically mandating a trial of generic Ketorolac or Diclofenac before approving Prolensa. Even with coverage, co-pays for brand-name Prolensa can be substantial.

Manufacturer Savings Programs

Bausch + Lomb Co-Pay Savings Card

Bausch + Lomb may offer co-pay assistance for Prolensa for commercially insured patients. Eligibility typically excludes government-funded insurance (Medicare, Medicaid, Tricare). Details and availability change — direct patients to bausch.com or have your staff check current program status.

Bausch + Lomb Access Program

For uninsured or underinsured patients who meet financial eligibility criteria, Bausch + Lomb's patient assistance program may provide Prolensa at no cost. Applications typically require income documentation and a prescriber signature.

Additional patient assistance options are listed on NeedyMeds (needymeds.org) and RxAssist (rxassist.org), which aggregate manufacturer and foundation programs.

Coupon and Discount Cards

For patients paying cash or facing high co-pays, pharmacy discount programs can meaningfully reduce out-of-pocket costs — especially for generic Bromfenac:

• GoodRx — Widely used, shows pricing at nearby pharmacies with downloadable coupons
• SingleCare — Similar coupon-based savings accepted at most chain pharmacies
• RxSaver — Price comparison tool with printable savings cards
• Optum Perks — Discount card program with broad pharmacy network
• BuzzRx, Inside Rx, America's Pharmacy — Additional options worth checking for best price

These programs work best for generic Bromfenac. Brand-name Prolensa discounts through coupon cards are typically modest.

Consider having your front desk or surgical coordinator look up pricing for the patient before the prescription is sent, so there are no surprises at the pharmacy.

Generic Alternatives and Therapeutic Substitution

The most impactful cost-saving measure is prescribing appropriately among the available ophthalmic NSAIDs:

Generic Bromfenac 0.07%

Therapeutically equivalent to brand Prolensa. Same active ingredient, same concentration, same once-daily dosing. Costs $80–$200 — roughly half to one-third the brand price. This should be the default for most patients unless there's a specific clinical reason to require the brand.

Ketorolac Ophthalmic (Generic Acular LS)

Available for as little as $15–$50 per bottle. The tradeoff is QID dosing, which reduces adherence — a real consideration for elderly patients managing multiple post-surgical drops. However, for cost-sensitive patients who are compliant and organized, it's a highly effective and affordable option.

Diclofenac Ophthalmic (Generic Voltaren Ophthalmic)

Another affordable QID option at $20–$60. Similar efficacy profile to Ketorolac for post-cataract inflammation.

Nepafenac (Nevanac 0.1% / Ilevro 0.3%)

Ilevro offers once-daily dosing like Prolensa but is typically brand-only and similarly priced. Nevanac 0.1% is TID dosing. Neither offers a significant cost advantage over generic Bromfenac.

For a patient-facing comparison, see our article on alternatives to Prolensa.

Building Cost Conversations into Your Workflow

The most effective way to prevent prescription abandonment is to address cost before the patient reaches the pharmacy. Consider these workflow integrations:

At the Pre-Operative Visit

• Discuss the post-surgical drop regimen and approximate costs — patients who know what to expect are less likely to abandon prescriptions
• Check insurance formulary status — if Prolensa requires PA or step therapy, start the process early or prescribe the formulary-preferred agent
• Prescribe generic Bromfenac by default — reserve brand Prolensa for cases with specific clinical justification
• Provide a savings card or GoodRx printout — particularly for uninsured or high-deductible patients

At the Surgical Coordinator Level

• Include medication costs in the pre-op packet — along with savings program information
• Help patients fill prescriptions before surgery day — this also avoids day-of availability issues (Prolensa has experienced supply disruptions)
• Use Medfinder for Providers to check pharmacy stock and help patients locate their medications

For Your Most Cost-Sensitive Patients

• Refer to patient assistance programs — Bausch + Lomb Access Program, NeedyMeds, RxAssist
• Consider therapeutic substitution — generic Ketorolac at $15–$50 with QID dosing may be preferable to non-adherence with a more expensive agent
• Explore in-office dispensing — if your practice has an in-office pharmacy, you may be able to offer competitive pricing and eliminate the pharmacy step entirely

Final Thoughts

Medication cost is one of the most predictable — and most addressable — barriers to postoperative adherence. For Prolensa specifically, the gap between brand ($250–$450) and generic Bromfenac ($80–$200) is significant, and the gap to generic Ketorolac ($15–$50) is even larger.

By defaulting to generics when clinically appropriate, initiating prior authorization early, providing savings resources proactively, and having honest cost conversations at the pre-op visit, you can meaningfully improve adherence rates and surgical outcomes.

For more practice resources, visit Medfinder for Providers. For patient-facing content you can share, see our guides on saving money on Prolensa and checking pharmacy stock.