Patient Assistance Services Are Available for RETISERT®
Bausch + Lomb is committed to helping eligible patients obtain affordable treatments*
FREE personalized patient assistance available through the Focus on Access (FOA) program offering*:
- Reimbursement counseling on RETISERT®:
- At your request, FOA counselors will see if the product prescribed is covered by your insurance
- FOA counselors can also assist you with information concerning the prior authorization process, claim denials, and the appeals process
- Eligibility for patient assistance for those without insurance coverage*
- You may be eligible if you do not have insurance coverage or if your product is not covered
*Terms, Conditions and Limitations Apply. Your doctor can refer you to the Focus on Access program to determine your eligibility for patient assistance. Insurance plans and coverage are subject to change. Bausch + Lomb does not guarantee coverage or reimbursement for the product.
For information on Reimbursement and Patient Assistance Services, Call the FOCUS ON ACCESS Hotline, (866) 272-8838 (Monday-Friday, 9 AM to 5 PM EST).
FAQs About Coverage and Reimbursement*
- If a claim is denied, an FOA counselor will assist you with information concerning the claim-appeal process
- You may also be considered for the Patient Assistance Program
- Continued assistance may be provided after you reapply to the program and you meet the pre-established eligibility criteria*
- In order to be considered for continued assistance, you must submit an application every 12 months*
- Eligibility to receive the product at no cost*
- You may be eligible based on:
- Lack of access to product prescribed
- Documentation of household income
- Proof of US residency
- You may be eligible based on:
- You need to fill out the Patient Information section of the FOA enrollment form
- Your doctor will provide you with this form
- The form will instruct you what information you need to supply
- Submit your filled out enrollment form with the necessary documents by mail or fax to:
FOCUS ON ACCESS PROGRAM
PO Box 220662
Charlotte, NC 28222-0662
FAX: (866) 272-8839
Please note: Faxed enrollment forms are acceptable
*Terms, Conditions and Limitations Apply. Your doctor can refer you to the Focus on Access program to determine your eligibility for patient assistance. Insurance plans and coverage are subject to change. Bausch + Lomb does not guarantee coverage or reimbursement for the product.
Indication
RETISERT® (fluocinolone acetonide intravitreal implant) 0.59 mg is used to treat an inflammation in the back of the eye that is not caused by an infection, called chronic non-infectious uveitis.
Important Safety Information
- RETISERT® (fluocinolone acetonide intravitreal implant) 0.59 mg should not be used if you have an infection of the eye from viruses, bacteria, fungi or fungal diseases.
- After receiving the RETISERT® implant, you should periodically see an eye doctor for follow-up examinations of both eyes.
- As with any surgical procedure, there is risk involved. Complications can include injury to the eye; infection; mechanical complication, movement or ejection of the implant; and wound complications following the surgery.
- After receiving the RETISERT® implant, nearly all patients will experience an immediate and temporary decrease in vision in the implanted eye that lasts for approximately 1 to 4 weeks following the surgery.
- Based on clinical studies, within 3 years after receiving the RETISERT® implant, approximately 77% of patients require medications to lower pressure in the eye, and approximately 37% of patients will require a surgical procedure to control pressure in the eye.
- Long-term use of corticosteroids may result in an increased risk of glaucoma (high pressure in the eye).
- Based on clinical studies, within 3 years after receiving the RETISERT® implant, nearly all patients who have not already had cataracts will develop them and require surgery.
- The most common side effects, occurring in 50-90% of patients, were cataract, increased pressure in the eye, surgery complications and eye pain. Headache was also reported in 33% of patients.
You are encouraged to report side effects to the FDA. To report SUSPECTED ADVERSE REACTIONS, contact Bausch + Lomb at 1‑800‑321‑4576 or FDA at 1‑800‑FDA‑1088 or www.fda.gov/medwatch.
Please click here for full Prescribing Information for RETISERT®.
Indication and Important Safety Information