Provider Briefing: Restasis Availability in 2026

Cyclosporine ophthalmic emulsion 0.05% — marketed as Restasis by Allergan (AbbVie) — remains a cornerstone of chronic dry eye management. However, the availability landscape has shifted considerably. While Restasis is not currently listed on the FDA's drug shortage database, providers across ophthalmology, optometry, and primary care are fielding increasing patient reports of difficulty filling prescriptions.

This article provides a clinical and logistical overview for prescribers navigating Restasis availability in 2026, including supply dynamics, formulary considerations, alternative agents, and tools to support patient access.

Timeline: How We Got Here

Restasis was FDA-approved in 2003 and enjoyed over two decades of market exclusivity as the first prescription treatment targeting the inflammatory component of dry eye disease. Key milestones include:

• 2003: FDA approval of Restasis (Cyclosporine 0.05% ophthalmic emulsion)
• 2016: Xiidra (Lifitegrast) approved, providing the first alternative mechanism for prescription dry eye treatment
• 2018: Cequa (Cyclosporine 0.09%) approved with nanomicellar delivery technology
• 2021: Tyrvaya (Varenicline nasal spray) approved for dry eye
• 2023: Miebo (Perfluorohexyloctane) approved for evaporative dry eye
• 2024: Generic Cyclosporine ophthalmic emulsion 0.05% enters the market following patent expiration

The entry of generics in 2024 was a watershed moment. While it significantly lowered costs for patients, it also introduced supply chain complexity as pharmacies, wholesalers, and PBMs adjusted their inventories and formularies.

Prescribing Implications

The generic transition has several practical implications for prescribers:

Formulary and Prior Authorization Changes

Most commercial and Medicare Part D plans have updated their formularies to prefer generic Cyclosporine over brand Restasis. Common requirements include:

• Mandatory generic substitution: Many plans will automatically substitute generic Cyclosporine when Restasis is prescribed
• Prior authorization: Both brand and generic may require PA, often with documentation of inadequate response to artificial tears
• Step therapy: Some plans require a trial of OTC artificial tears before approving any prescription dry eye treatment
• Tier placement: Brand Restasis is typically placed on specialty or non-preferred tiers with higher copays

Writing Prescriptions for Optimal Access

To minimize pharmacy delays for your patients:

• Write for "Cyclosporine ophthalmic emulsion 0.05%" rather than "Restasis" to allow generic dispensing
• Include "DAW 0" (dispense as written — substitution permitted) unless there's a clinical reason to require brand
• Pre-complete prior authorization paperwork when possible, especially for patients with known insurance requirements
• Document previous treatment failures (artificial tears, punctal plugs) in the chart to expedite PA approval

Current Availability Picture

As of early 2026, the availability situation can be summarized as follows:

• Brand Restasis: Available but stocked less frequently at retail pharmacies as generic adoption increases. More reliably available through mail-order and specialty pharmacies.
• Generic Cyclosporine 0.05%: Widely available from multiple manufacturers. Pricing with discount cards ranges from $85 to $150 for a 60-vial box.
• Cequa (Cyclosporine 0.09%): Available but often requires PA. Higher cost point.
• Xiidra, Miebo, Tyrvaya: Available as alternatives with varying insurance coverage.

Cost and Access Considerations

Cost remains a primary barrier to treatment adherence for many dry eye patients:

• Brand Restasis without insurance: $350–$410 per 30-day supply
• Generic Cyclosporine with discount card: $85–$150 per 30-day supply
• Xiidra without insurance: $500+ per month
• Patient assistance: AbbVie Patient Assistance Foundation offers brand Restasis at no cost for qualifying uninsured/underinsured patients

For patients struggling with cost, the AbbVie savings program (for commercially insured patients) and third-party discount cards through services like SingleCare or GoodRx can significantly reduce out-of-pocket costs. Refer patients to our guide on saving money on Restasis.

Tools and Resources for Providers

Several tools can help you and your staff navigate availability challenges:

Medfinder for Providers

Medfinder offers real-time pharmacy availability data. Your staff can use it to identify pharmacies that currently have Cyclosporine ophthalmic in stock before sending a prescription, reducing patient frustration and callback volume.

Prior Authorization Support

Consider using electronic prior authorization (ePA) platforms integrated with your EHR. These can reduce turnaround time from days to hours for many insurers.

Patient Education Resources

Direct patients to reliable information to help them understand their options:

• What is Restasis: uses, dosage, and what you need to know
• Alternatives to Restasis
• How to find Restasis in stock

Looking Ahead

The dry eye treatment landscape continues to evolve. With multiple generic Cyclosporine manufacturers now in the market, availability and pricing should stabilize further through 2026. Meanwhile, the expanding range of mechanism-based treatments — from LFA-1 antagonists to tear neurostimulation to lipid-layer stabilizers — gives prescribers more options to individualize therapy.

Staying informed about formulary changes and supply dynamics will remain important for providing seamless care. For the latest availability data, visit Medfinder for Providers.

Final Thoughts

Restasis is not in shortage, but the market is in transition. Prescribers who proactively write for generic Cyclosporine, streamline prior authorizations, and leverage real-time availability tools can significantly reduce patient access barriers. For a complementary resource, see our guide on how to help your patients find Restasis in stock.