Perfluorohexyloctane eye drops (Miebo)

How Medicare covers it

Part D (forms used at home). Part A during a covered inpatient stay. No Part B clinician-administered form in the CMS Part B spending file.

What it treats

Treatment of the signs and symptoms of dry eye disease (DED).

What it is for, in depth

MIEBO is a prescription eye drop used only for the signs and symptoms of dry eye disease — the label lists no other use. It is a sterile, clear, colorless liquid that is 100% perfluorohexyloctane, made for use on the surface of the eye (topical ophthalmic use). The dose is the same for the condition: one drop in each eye, four times a day. It is supplied in a multiple-dose bottle with a dropper tip and screw cap; each multiple-dose bottle contains 3 mL of perfluorohexyloctane, and the product is packaged in a 5 mL polypropylene bottle. It should be stored at 15°C to 25°C (59°F to 77°F), and after opening it can be used until the expiration date on the bottle.

How it works

Perfluorohexyloctane is a semifluorinated alkane. It forms a thin single layer (a monolayer) where the tear film meets the air, which can be expected to reduce how fast the tears evaporate. The label states that the exact way MIEBO works in dry eye disease is not known.

How it is taken

Put one drop into each eye four times a day. Do not use it while wearing contact lenses: take your lenses out before using it, and wait at least 30 minutes after using it before putting them back in.

Common side effects

The most common eye side effect was blurred vision. Blurred vision was reported in less than 4% of individuals.

Serious warnings

The label sections provided list no serious warnings beyond the items here. MIEBO must not be used by people with hypersensitivity (allergy) to it, and it should not be put in while wearing contact lenses — lenses should be removed beforehand and left out for at least 30 minutes after use.

Who should be careful

People who are allergic (hypersensitive) to perfluorohexyloctane must not use it, and contact lens wearers must follow the lens removal rule above. For pregnancy, the label says there are no adequate and well controlled studies of MIEBO in pregnant women; in animal studies using the drug by mouth during pregnancy, no harmful effects on mothers or offspring were seen in rats at doses up to 162 times the recommended human eye dose, while harmful effects on mothers, miscarriages, and lower fetal weights were seen in rabbits at all doses tested, the lowest being 41 times the recommended human eye dose.

Major interactions

The label sections provided do not include a drug interactions section, so no specific drug interactions are listed for MIEBO in this label.

Cost and saving notes

Medicare Part D plans place drugs on tiers, and a higher tier usually means a higher copay or coinsurance. If your doctor says you need this drug and your plan's tier makes it costly, you or your doctor can ask the plan for a tier exception. If you have limited income, the Extra Help program (the Part D Low Income Subsidy) may lower your Part D premium, deductible, and drug costs if you qualify.

Why it is in its tier

Perfluorohexyloctane eye drops (Miebo) sits on Tier 3 in 52.23% of the plans that list it (2516 of 4817 listing plans). Tier 3 is the preferred brand tier — mid-level copays or coinsurance. The data-visible drivers: It is a brand-only product with no generic version in the formulary data, and the CMS dashboard puts its average Part D spending at about $2,394 per beneficiary for 2024 — a mid-cost drug, which matches where plans place it. It is listed by 87.66% of Part D plans. The tier shown is the most common one; individual plans vary.

Sources

• MIEBO (PERFLUOROHEXYLOCTANE) SOLUTION [BAUSCH & LOMB INCORPORATED] — DailyMed
• MedlinePlus — National Library of Medicine
• MedlinePlus — Perfluorohexyloctane ophthalmic

What official patient guides say

Perfluorohexyloctane ophthalmic comes as a solution (liquid) to place into the eye, usually used four times a day, and contact lenses should be removed before using the eye drops and kept out for at least 30 minutes after using it. Use it exactly as directed — do not use more or less of it or use it more often than prescribed — shake the liquid well before each use to mix the medication evenly, and continue to use it even if your symptoms improve, because it controls dry eye disease but does not cure it, and do not stop using it without talking to your doctor. To use the drops: wash your hands, remove contact lenses, and remove the cap from the bottle; holding the bottle upright, gently squeeze it, and while squeezing turn the bottle upside down and stop squeezing; keeping the bottle upside down, place it above your eye and squeeze 1 drop into the affected eye, then repeat the steps for the second eye if needed. If you forget a dose, place the missed dose in your eye(s) as soon as you remember it, but if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule; do not apply extra eye drops to make up for a missed dose. Store it in the container it came in, tightly closed and out of reach of children, at room temperature and away from excess heat and moisture (not in the bathroom).

Source: MedlinePlus — Perfluorohexyloctane ophthalmic

Part D formulary coverage

Source: CMS Prescription Drug Plan Formulary, Pharmacy Network, and Pricing Information Files — Monthly file 2026-10-15 (plan year 2027), file 2027_20261008.zip (data.cms.gov dataset ed1496ea-23e7-41f1-9292-172fa842ccfb): basic drugs formulary file + plan information file, both dated 20261031 inside the zip; downloaded and aggregated 2026-10-30. Medication RxCUI sets resolved through the NLM RxNav (RxNorm) API.

What you pay

Without insurance, the cash benchmark is 263.58242 per unit (MIEBO 100% EYE DROP) — about nan for 30 units. NADAC benchmark — the average price pharmacies pay (CMS, as of 2026-11-04). Pharmacy shelf prices vary.

A tier is not a price; what you pay depends on your plan, pharmacy, and benefit stage; Extra Help or Medicaid can lower it further.

Sources: CMS Plan Benefit Package + formulary data; CMS NADAC · Checked 2026-11-08

Coverage by plan and tier

Of the 5,495 Medicare drug plans we track for 2027, 4,817 list Perfluorohexyloctane eye drops (Miebo) — 87.7% of plans. Most of those plans put it on Tier 3: 2,516 plans, 52.2% of the plans that list it. Other plans place it on Tier 4 (2,119 plans), Tier 1 (111 plans) or Tier 2 (71 plans). For example: Aetna Medicare Dual Extra (HMO D-SNP) puts it on Tier 3; Aetna Medicare Dual Extra Care (PPO D-SNP) puts it on Tier 3; Aetna Medicare Value Plus (PPO) puts it on Tier 3. You can compare these plans side by side on our Medicare Advantage hub. A tier is not a price. What you pay also depends on whether you have met your plan';s deductible, whether the drug costs a flat copay or a share of the price, and whether you get Extra Help or Medicaid.

Read next

• Part D in 2027: The $700 Deductible, the $2,400 Cap, and the $35 Insulin Rule
• Extra Help in 2027: Lower Drug Copays and Who Qualifies
• Checking Medicare Savings Programs and Extra Help

Part D spending averages (2024)

Source: CMS Medicare Part D Spending by Drug (Drug Spending Dashboard), release RY26 P04 V10, data through 2024 (DSD_PTD_RY26_P04_V10_DY24_BGM.csv), downloaded 2026-10-30

Companies covering this drug

Part D and Medicare Advantage plan sponsors that list this drug on a formulary, 50 at a time.