SYSTANE ULTRA 0.4-0.3% EYE DRP
FDA nonproprietary name: polyethylene glycol 400 and propylene glycol
For 1 mL
Pharmacies pay
$0.59 – $1.09 filed
1 × $0.58867 to $1.09331 per ML (the 4 NDCs differ)
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
$5.68 – $6.25 estimated
NADAC for the pack + 15% + $5.00 fee per fill
This is a model, not a price any pharmacy quoted. Shipping is not included. For a pack this cheap, the $5.00 fee is most of the estimate. How it is worked out
OpenBill calculation · nadac-national-average-drug-acquisition-cost-20261014.csv · NADAC eff. 2026-09-23 (file of 2026-10-14, retrieved 2026-10-17)
Open the interactive card Change the quantity, type what you were charged, and see every record in full.
What it is
SYSTANE ULTRA 0.4-0.3% EYE DRP 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 Ultra”.
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 4 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 $0.59 – $1.09 for 1 mL, depending on the NDC ($0.58867 to $1.09331 per ML), 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.
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.
What NADAC measures · NADAC explanation codes
All 4 NDCs
- 00065-1431-05 · Alcon Laboratories, Inc. · $1.02993 per ML · eff. 2026-09-23 filed
- 00065-1431-21 · Alcon Laboratories, Inc. · $0.58867 per ML · eff. 2026-09-23 filed
- 00065-1431-28 · Alcon Laboratories, Inc. · $1.09331 per ML · eff. 2026-09-23 filed
- 00065-1431-41 · Alcon Laboratories, Inc. · $0.84667 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 ULTRA 0.4-0.3% EYE DRP.
| 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% | $0.37625 per EA; $1.15528 per ML filed | We don’t know yet |
| SYSTANE ULTRA 0.4-0.3% EYE DRP this page | $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 1 mL? Is it lower than what I would pay through my insurance?
- Which NDC (the 11-digit number on the package) is this? Pharmacies pay $0.58867 to $1.09331 per ML for this product, depending on the NDC.
- It is sold over the counter, so shelf prices vary from store to store: what does it cost per unit here?
- How much is in the package I am getting? This page uses 1 mL; your package may hold a different amount.
- These are questions about price, not medical advice. Do not change or stop a medicine without talking to your prescriber or pharmacist.
Questions
- Why does this page start at 1 mL?
- The FDA package descriptions of this product’s NDCs give different amounts (3 mL, 8 mL, 10 mL, 20 mL). So the card starts at 1 ML; change it to match your prescription.