iLink® Patient Savings Program Terms & Conditions
Program Terms, Conditions, and Eligibility Criteria:
- Offer valid only for commercially insured patients who are prescribed Photrexa® drug formulations for on-label use with the iLink cross-linking procedure and whose insurance plan covers the iLink cross-linking procedure.
- Offer not valid for use by patients receiving reimbursement under any federal, state,
or government-funded healthcare programs (e.g., Medicare, Medicare Advantage,
Medigap, Medicaid, TRICARE, Department of Defense, or Veterans Affairs programs);
private indemnity or HMO insurance plans that reimburse patients for the entire cost of
their prescription drugs; or where prohibited by the patient’s health insurance provider.
This offer is not valid for cash-paying patients. This offer is also not valid for commercially
insured patients whose insurance plans do not cover the iLink cross-linking procedure or
whose claim was denied as being off-label or not medically necessary. - Subject to insurance coverage, eligible commercially insured patients may get up to $600
per eye towards non-reimbursable copay expenses for the Photrexa® drug formulations
[Photrexa® Viscous (riboflavin 5’-phosphate in 20 % dextran ophthalmic solution), Photrexa®
(riboflavin 5’-phosphate ophthalmic solution)] used in the iLink cross-linking procedure. This
offer applies to the out-of-pocket costs for the pharmaceutical fee only and does not apply
to costs for any other medication, procedure, or diagnostic service. Patient out-of-pocket
expenses will vary. - Offer applies to to procedures completed during the current program offering period
ending September 30, 2026. Savings requests must be submitted within 180 days of the
treatment date (no later than March 31, 2027) and include a copy of an Explanation of
Benefits (EOB) identifying J2787 for the Photrexa drug formulations and confirmation from
the healthcare provider of the on-label diagnosis. - Glaukos reserves the right to rescind, revoke, or amend this offer without notice.
- Offer good only in the USA, including Puerto Rico and Guam. Patients residing in or receiving
treatment in certain states may not be eligible to participate in this program. - Void if prohibited by law, taxed, or restricted.
- Offer is nontransferable. The selling, purchasing, trading, or counterfeiting of this offer is
prohibited by law. - Offer has no cash value and may not be used in combination with any other discount,
coupon, rebate, free trial, or similar offer for the specified prescription. - This offer is not health insurance.
- Program expires September 30, 2026.
- By redeeming this offer, patient must meet the eligibility criteria above and patient
understands and agrees to comply with the terms and conditions of this offer. Receipt of
the benefit is dependent on patient completion and approval by Glaukos of the program
application. For questions about the program, please call 1-833-855-3031 or email GPS@
glaukos.com. - Photrexa Viscous® and Photrexa for use with the KXL® System was discontinued from the
market effective January 31, 2026. Limited supply of Photrexa remains available within the
distribution network.
Glaukos reserves the right at any time to delete, modify, or change the terms and conditions without notice.