How to Help Your Patients Find Ilevro in Stock: A Provider's Guide

For ophthalmologists performing cataract surgery, the post-operative medication experience is part of the surgical outcome. When patients struggle to fill their Ilevro prescription — whether due to stock availability, cost, or insurance delays — it directly impacts their recovery.

This guide provides a practical, step-by-step framework for helping your patients successfully fill their Ilevro prescriptions before cataract surgery.

Step 1: Set Expectations at Prescription Time

Before the patient leaves your office, prepare them for potential pharmacy challenges. A brief conversation or printed instruction sheet can prevent last-minute crises:

Tell them Ilevro is a specialty eye drop that not all pharmacies routinely stock

Advise them to fill the prescription at least 3-4 days before surgery, not the day before

Provide your office phone number prominently so they can call immediately if they encounter problems

Share the Harrow Connects Savings Program information (harrowconnects.com) to address cost concerns upfront

Step 2: Build a Preferred Pharmacy Relationship

Establish a relationship with 1-2 pharmacies near your surgical center that agree to maintain reliable Ilevro inventory. Share your approximate monthly cataract volume so they can calibrate stock levels. A pharmacy that knows you send 30+ Ilevro prescriptions per month will proactively maintain stock.

When communicating this pharmacy preference to patients, print the name, address, phone number, and hours on your pre-op instruction sheet. Patients who know exactly where to go have far fewer fill failures than those who default to wherever is most convenient.

Step 3: Address Insurance Barriers Before Surgery Day

Ilevro sits on Tier 3 of most Medicare Part D formularies, and some commercial plans require prior authorization or step therapy. Consider these proactive steps:

Submit PA requests early. For Medicare patients scheduled more than 2 weeks out, have your prior authorization staff initiate the request at time of surgery scheduling — not the week before surgery.

Know your formulary alternatives. If a payer denies Ilevro, identify which lower-tier NSAID they prefer (often generic ketorolac or bromfenac) so you can quickly issue a substitution prescription without delay.

Inform patients about copay programs. The Harrow Connects card reduces copay to as low as $59 for commercially insured patients. GoodRx can bring cash price to approximately $149. Many patients who abandon prescriptions at the counter would fill them with these savings programs.

Step 4: Direct Patients to medfinder for Availability Searches

When a patient calls reporting they can't find Ilevro, rather than spending staff time on pharmacy hold calls, direct them to medfinder. medfinder calls pharmacies near the patient to check which ones actually have Ilevro in stock and can fill the prescription. Results are texted to the patient directly.

This is particularly valuable for patients who are less mobile, unfamiliar with pharmacy options in your area, or dealing with pre-surgical stress. Instead of calling 8 pharmacies themselves — often reaching hold queues or getting inaccurate information from staff who haven't checked actual stock — medfinder provides verified results.

Step 5: Keep Samples Available for Emergency Bridge Situations

Work with your Harrow pharmaceutical representative to maintain a supply of Ilevro samples. For patients who arrive the day before surgery unable to fill their prescription, a sample to cover the pre-operative dose can be the difference between proceeding safely and canceling the procedure.

Note: sample bottle volumes are typically 1.7 mL. For the full post-operative course, the patient will still need a 3 mL prescription fill, but bridge samples resolve the critical pre-surgical dosing issue.

Step 6: Know When to Switch to an Alternative

If a patient is under 72 hours from surgery and cannot locate Ilevro, proceeding with an alternative ophthalmic NSAID is preferable to no pre-treatment. The equivalence hierarchy for most routine cataract cases:

Generic bromfenac 0.07% (once daily) — best compliance and efficacy match to Ilevro

Generic ketorolac 0.5% (QID) — widely stocked, most affordable, proven efficacy

Generic diclofenac 0.1% (QID) — broad availability, good cost-effectiveness

Building a Systematic Pre-Op Medication Protocol

The most effective practices reduce medication fill failures through systematic protocols rather than reactive case-by-case management:

Send electronic prescriptions (e-Rx) to the preferred pharmacy at time of surgical scheduling — not at the pre-op visit

Include a pharmacy confirmation step in your pre-op nursing call ("Has the patient filled their eye drops?")

Maintain a standardized alternatives order set so staff can quickly issue a substitution without requiring physician interruption

Document Ilevro vs. alternative selection in your peri-operative notes for post-operative outcome tracking

For more on current availability status and the broader clinical context, see our Ilevro shortage update for providers.