SYSTANE HYDRATION PF 0.4-0.3%
FDA nonproprietary name: polyethylene glycol 400 and propylene glycol
Per unit: no single pack total
Pharmacies pay
$0.37625 per EA; $1.15528 per ML filed
These NDCs are priced per different units (EA, ML), so there is no single pack total for a quantity of 1; see the price for each NDC.
CMS NADAC · nadac-national-average-drug-acquisition-cost-20261014.csv · eff. 2026-09-23 · as of 2026-10-14 · retrieved 2026-10-17
Medicare
We don’t know yet
No Medicare reference price. Part D: OpenBill did not match this NDC to a usable Medicare Part D spending row. Either Part D has none for it, or the rows that share its name could not safely be tied to it (for example, they mix units, routes or release forms, or the drug is sold over the counter, which Part D does not cover). Part B: This NDC is not in the current quarter’s Medicare Part B NDC-HCPCS crosswalk, so it has no Part B payment limit.
The spread
We don’t know yet
There is no Medicare figure to compare with, so there is no spread.
Cost-plus estimate
We don’t know yet
These NDCs are priced per different units (EA, ML), so there is no single pack total for a quantity of 1; see the price for each NDC.
Open the interactive card Change the quantity, type what you were charged, and see every record in full.
What it is
SYSTANE HYDRATION PF 0.4-0.3% is how the CMS NADAC file names this product. The FDA NDC Directory lists it as polyethylene glycol 400 and propylene glycol, under the trade name “SYSTANE HYDRATION PF PRESERVATIVE FREE”.
FDA gives its dosage form as solution/ drops and its route as ophthalmic.
The labeler, the company named on the label, is Alcon Laboratories, Inc.
FDA lists no Established Pharmacologic Class for it.
The NADAC file of 2026-10-14 prices it under 2 NDCs (National Drug Codes).
NADAC classes it as a brand-name drug (rate-setting class B), and marks it as sold over the counter.
What pharmacies pay
Pharmacies pay $0.37625 per EA; $1.15528 per ML for it, depending on the NDC, by the CMS NADAC file of 2026-10-14; that price took effect on 2026-09-23. That is what pharmacies pay their suppliers, not what they charge you.
There is no single total for a pack: These NDCs are priced per different units (EA, ML), so there is no single pack total for a quantity of 1; see the price for each NDC.
NADAC’s explanation codes for it: 1, calculated from the most recently completed pharmacy survey; 5, calculated based on package size; 6, the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.
NADAC also lists, on the row of one brand NDC, what pharmacies pay for the generic equivalent, a different product: $0.20368 per EA filed.
CMS NADAC · nadac-national-average-drug-acquisition-cost-20261014.csv · eff. 2026-09-23 · as of 2026-10-14 · retrieved 2026-10-17
What NADAC measures · NADAC explanation codes
All 2 NDCs
- 00065-1437-04 · Alcon Laboratories, Inc. · $0.37625 per EA · eff. 2026-09-23 filed
- 00065-1510-06 · Alcon Laboratories, Inc. · $1.15528 per ML · eff. 2026-09-23 filed
Other strengths, forms and brands
6 other products in the NADAC file share the FDA nonproprietary name polyethylene glycol 400 and propylene glycol with SYSTANE HYDRATION PF 0.4-0.3%.
| Product | Pharmacies pay per unit | Medicare per unit |
|---|---|---|
| GENTEAL TEARS SEVERE GEL DROPS | $1.08984 per ML filed | We don’t know yet |
| LUBRICANT 0.4-0.3% EYE DROP | $0.36253 per ML filed | We don’t know yet |
| SYSTANE 0.4-0.3% EYE DROP | $0.56795 to $0.70184 per ML filed | We don’t know yet |
| SYSTANE GEL EYE DROPS | $1.13016 per ML filed | We don’t know yet |
| SYSTANE HYDRATION PF 0.4-0.3% this page | $0.37625 per EA; $1.15528 per ML filed | We don’t know yet |
| SYSTANE ULTRA 0.4-0.3% EYE DRP | $0.58867 to $1.09331 per ML filed | We don’t know yet |
| SYSTANE ULTRA PF 0.4-0.3% EYE | $1.15528 per ML filed | We don’t know yet |
CMS NADAC · nadac-national-average-drug-acquisition-cost-20261014.csv · eff. 2026-04-22, 2026-09-23 · as of 2026-10-14 · retrieved 2026-10-17
What Medicare paid
We don’t know yet; the card above says why.
Which Medicare figure OpenBill compares · How Part D is matched · How Part B is matched
What to ask at the counter
None of these figures is your price: what you pay depends on your pharmacy, your insurance, coupons and discounts.
- What is your cash price for the amount I was prescribed? Is it lower than what I would pay through my insurance?
- It is sold over the counter, so shelf prices vary from store to store: what does it cost per unit here?
- These are questions about price, not medical advice. Do not change or stop a medicine without talking to your prescriber or pharmacist.