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iLink® Patient Savings Program Terms & Conditions


The iLink Patient Savings Program (“Program”) is valid ONLY for patients with commercial (private or non-governmental) insurance who are prescribed Photrexa® drug formulations for the Food and Drug Administration (FDA)-approved indications for the iLink cross-linking procedure. Patients using Medicare, Medicaid, Medigap, Veterans Affairs (VA), Department of Defense (DoD), TRICARE or any other federal or state government program (collectively, “Government Programs”) to pay for iLink and/or administration services are not eligible. The Program is not valid if the costs are eligible to be reimbursed in their entirety by private insurance plans or other programs.

Under the Program, the patient may get up to $550 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. Patient out-of-pocket expenses will vary. The total patient out-of-pocket cost is dependent on the patient’s health insurance plan. This offer applies to the out-of-pocket costs for the pharmaceutical fee only and does not apply to costs for any other administrations, medications, procedures, diagnostic services, or office visit fees. The Program benefit amounts cannot exceed the patient’s out-of-pocket expenses for the iLink cross-linking procedure. The Program is not health insurance or a benefit plan. The patient’s non-governmental insurance is the primary payer.

The patient or their guardian must be 18 years of age or older to receive assistance from the Program. The Program is only valid in the United States and U.S. Territories and are void where prohibited by law.

Once a patient is enrolled, the Program will honor claims with a date of service that precedes Program enrollment by 180 days. Claims must be submitted within 180 days from the date of service unless otherwise indicated. Use of this Program must be consistent with all relevant health insurance requirements. Participating patients, pharmacies, physicians’ offices and hospitals are responsible for reporting the receipt of all the Programs’ benefits as required by any insurer or by law. Program benefits may not be sold, purchased, traded or offered for sale.

The value of the Program is intended exclusively for the benefit of the patient. The funds made available through the Program may only be used to reduce the out-of-pocket costs for the patient enrolled in the Program.

Glaukos reserves the right at any time to delete, modify, or change the terms and conditions without notice.
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Important Safety Information

Ulcerative keratitis, a potentially serious eye infection, can occur. Your doctor should monitor defects in the outermost corneal layer of the eye for resolution.

The most common ocular side effect is haze. Other ocular side effects include inflammation, fine white lines, dry eye, disruption of surface cells, eye pain, light sensitivity, reduced sharpness of vision, and blurred vision. The risk information provided here is not comprehensive. To learn more, talk to your healthcare provider.

Go to Prescribing Info to obtain the FDA-approved product labeling.

You are encouraged to report all side effects to the FDA. Visit www.fda.gov/safety/medwatch-fda-safety-information-and-adverse-event-reporting-program, or call 1-800-FDA-1088.

Approved Uses

Photrexa® Viscous (riboflavin 5’-phosphate in 20% dextran ophthalmic solution) and Photrexa® (riboflavin 5’-phosphate ophthalmic solution) are used with the KXL® System in corneal cross-linking to treat eyes in which the cornea, the clear dome shaped surface that covers the front of the eye, has been weakened from the progression of the disease keratoconus or following refractive surgery, a method for correcting or improving your vision.

Tell your healthcare provider if you are pregnant or plan to become pregnant.