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With the Patient Assistance Program from HealthWell Foundation, contact the program to see how they can financially help you out.

| Dosage | Quantity | Retail price | GoodRx price |
|---|---|---|---|
| 10mg | 20 tablets | $30.76 | $10.32 |
| Dosage | Quantity | Retail price | GoodRx price |
|---|---|---|---|
| 1ml vial of 15mg/ ml | 1 carton | $66.50 | $17.08 |
| 1ml vial of 30mg/ ml | 1 carton | $98.68 | $18.14 |
| 2ml vial of 60mg/ 2ml | 1 carton | $52.13 | $21.76 |
| Dosage | Quantity | Retail price | GoodRx price |
|---|---|---|---|
| 5ml of 0.4% | 1 eye dropper | $68.29 | $25.24 |
| 3ml of 0.5% | 1 eye dropper | $50.44 | $17.77 |
| 5ml of 0.5% | 1 eye dropper | $93.50 | $15.42 |
| 10ml of 0.5% | 1 eye dropper | $135.25 | $25.91 |
| Dosage | Quantity | Retail price | GoodRx price |
|---|---|---|---|
| 5 bottles of 15.75mg/ spray | 1 package | $2,572.02 | $1,781.88 |
| Dosage | Quantity | Retail price | GoodRx price |
|---|---|---|---|
| 1ml of 30mg/ ml | 1 syringe | $12.42 | $10.55 |
| 2ml of 60mg/ 2ml | 20 syringes | $43.74 | $22.09 |
| Dosage | Quantity | Retail price | GoodRx price |
|---|---|---|---|
| 1ml of 15mg/ ml | 1 vial | N/A | $5.87 |
| 1ml of 30mg/ ml | 10 vials | $37.91 | $14.47 |
| 2ml of 60mg/ 2ml | 5 vials | $24.55 | $14.00 |

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