Vevye Shortage: What Providers and Prescribers Need to Know in 2026

Clinical Summary: Vevye Access and Availability in 2026

Vevye (cyclosporine ophthalmic solution 0.1%) is not on the FDA's official drug shortage list in 2026. Supply is available through McKesson, Cardinal Health, and Cencora and can be ordered by any retail pharmacy within approximately 24 hours. However, access barriers — primarily insurance prior authorization requirements, step therapy policies, and formulary placement — continue to create friction for prescribers and their patients.

Current Vevye Coverage and Formulary Status

Coverage has expanded meaningfully in 2025. As of January 2025, Vevye is included on key Medicare Part D formularies managed by Express Scripts, Cigna, Kaiser Permanente, and CVS Caremark — collectively covering more than 25 million Medicare Part D beneficiaries. Vevye is also covered by all U.S. Medicaid programs and approximately 60% of commercial insurance providers.

Despite this improved coverage, prior authorization remains common on many plans, and step therapy edits requiring failure of generic cyclosporine 0.05% first are frequently encountered. The administrative burden for both clinical staff and patients remains substantial.

The VEVYE Access for All Program: Key Details for Prescribers

Launched March 17, 2025, VEVYE Access for All (VAFA) is Harrow's most significant access initiative. Key features for prescribers:

• No prior authorization: Prescribers send the prescription to PhilRx directly via their EMR system
• Flat-rate $59 pricing: Cash-pay patients receive Vevye at $59 per bottle through PhilRx
• Eligible commercially insured patients may pay as little as $0
• Free home delivery with no delay
• Prescription workflow: EMR to PhilRx — minimal to no staff PA burden
• NOT valid for Medicare, Medicaid, Tricare, VA, DOD, or other government programs

In April 2025, the program was expanded to facilitate transitions for patients using compounded cyclosporine 0.1% (Klarity-C). Prescribers can transfer prescriptions to PhilRx in under 5 minutes via a dedicated authorization platform.

Navigating Prior Authorization When Required

For patients on insurance that still requires PA, supporting documentation should include:

• Diagnosis of dry eye disease with documented signs and/or symptoms
• Inadequate response to artificial tears and/or other OTC interventions
• Clinical rationale for Vevye: first and only cyclosporine indicated for both signs and symptoms; water-free preservative-free formulation; demonstrated efficacy at 4 weeks
• For step therapy edits: document any prior trial of generic cyclosporine 0.05%, including response and tolerance

Harrow's patient support line (833-442-7769) provides assistance with PA submissions and support templates.

Clinical Differentiation: Vevye vs. Other Cyclosporine Products

• Concentration: Vevye 0.1% — the highest commercially available — vs. Cequa 0.09% vs. Restasis 0.05%
• FDA indication: Vevye is the only cyclosporine with an indication for both signs AND symptoms of DED
• Vehicle: Water-free perfluorobutylpentane vs. aqueous emulsion (Restasis) or nanomicellar (Cequa)
• Onset: Benefits demonstrated as early as 15 days; sustained over 12 months
• Tolerability: No preservatives, no water, no oils or surfactants

Clinical Trials Overview

The VEVYE clinical development program enrolled 1,369 patients, of whom 738 received at least one dose. Trials demonstrated statistically significant improvement in both corneal staining (total corneal fluorescein staining, tCFS) and patient-reported symptoms. Vevye showed greater improvement in corneal and conjunctival staining compared to vehicle and Restasis over a four-month period.

Most common adverse reactions: instillation site reactions (8%) and temporary decreases in visual acuity (3%).

Counseling Points for Patients Starting Vevye

• One drop in each eye twice daily, approximately 12 hours apart
• Remove contact lenses before use; reinsert after 15 minutes
• If using other eye drops, allow 15 minutes between products
• Store at room temperature (59-77 degrees F); do not freeze
• One bottle lasts approximately 30 days with proper administration

Alternatives to Discuss If Vevye Remains Inaccessible

• Generic cyclosporine 0.05% (generic Restasis): ~$90/month with discount; appropriate for step therapy documentation
• Cequa (cyclosporine 0.09%): $89/month through Cequa Direct Pricing without insurance
• Xiidra (lifitegrast 5%): Different mechanism (LFA-1 antagonist); good for cyclosporine non-responders
• Miebo (perfluorohexyloctane): Best for primarily evaporative DED; four times daily dosing
• Tyrvaya (varenicline nasal spray): Non-drop option via trigeminal-parasympathetic stimulation

Medfinder: A Tool for Your Practice

Medfinder helps patients locate medications in stock at nearby pharmacies. Directing your patients to Medfinder can reduce the calling-around burden and help them locate Vevye or alternatives quickly.

Visit Medfinder for Providers to learn how Medfinder supports eyecare practices.

Related: How to help your patients find Vevye in stock: a provider's guide