Hepatitis C is a liver disease caused by the hepatitis C virus (HCV). Although the virus can clear on its own, most people need treatment. Insurance may help cover some or all of the cost. Financial assistance programs are also available.
Years ago, people with hepatitis C essentially had only two treatment options: pegylated interferon and ribavirin. These treatments didn’t cure the disease in everyone who took them, and they came with a long list of side effects. Plus, they were only available as injections.
New antiviral drugs are now available in pills. They work quickly and are much more effective than older treatments. These drugs cure hepatitis C in more than
The one downside to new hepatitis C treatments is their steep price tag. Read on to learn about the high costs of hepatitis C drugs and how to cover them.
More than a dozen treatments are available to treat hepatitis C. Older drugs still used include:
- peginterferon alfa-2a (Pegasys)
- peginterferon alfa-2b (PEG-Intron)
- ribavirin (Copegus, Rebetol, Ribasphere)
New antiviral drugs include:
- daclatasvir (Daklinza)
- elbasvir/grazoprevir (Zepatier)
- glecaprevir/pibrentasvir (Mavyret)
- ledipasvir/sofosbuvir (Harvoni)
- ombitasvir/paritaprevir/ritonavir (Technivie)
- ombitasvir/paritaprevir/ritonavir/dasabuvir (Viekira Pak)
- simeprevir (Olysio)
- sofosbuvir (Sovaldi)
- sofosbuvir/velpatasvir (Epclusa)
- sofosbuvir/velpatasvir/voxilaprevir (Vosevi)
Which of these drugs or combinations of drugs your doctor prescribes depends on:
- the virus genotype
- the overall viral load
- the extent of any liver damage
- prior treatments for hepatitis C
- overall medical history, including other health conditions you may have
Antiviral drugs for hepatitis C are very effective, but they come at a steep cost. Just one Sovaldi pill costs $1,000. A full 12-week course of treatment with this drug costs $84,000.
The price of other hepatitis C drugs is also high. For a 12-week treatment:
- Harvoni costs $94,500
- Technivie costs $76,653
- Zepatier costs $54,600
- Mavyret costs $39,600
Hepatitis C drugs are expensive due to the large demand for them and the high cost of bringing them to market. Developing a new drug, testing it in clinical trials, and marketing it can cost pharmaceutical companies nearly $900 million.
Another factor adding to the high cost is the lack of a national healthcare system to negotiate medication costs on behalf of consumers. There’s also little competition from other drug companies. As a result, hepatitis C drug manufacturers can charge whatever they want.
Prices could drop in the future as more pharmaceutical companies get into the hepatitis C drug market. The introduction of generic versions of these drugs should help drive costs down.
Not everyone with hepatitis C needs treatment.
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Your doctor will monitor you closely to see whether your condition persists and decide if you need treatment.
Some insurance companies try to combat the high cost of hepatitis C drugs by rejecting coverage for them.
More than one-third of people in the United States were denied coverage for these drugs by their insurance company, according to a 2018 study.
Private insurance companies rejected more claims for these drugs — over 52% — than Medicare or Medicaid.
Medicare and Medicaid are more likely to approve hepatitis C drug coverage. But with Medicaid, you might have to meet certain requirements to receive these drugs, such as:
- getting a referral from a specialist
- having signs of liver scarring (cirrhosis)
- taking periodic drug tests to demonstrate sobriety from alcohol and other substances
If you don’t have health insurance, your insurance company refuses to pay for your hepatitis C drugs, or your out-of-pocket costs are too high for you to pay, assistance is available from the following companies and organizations:
- The American Liver Foundation has partnered with NeedyMeds to create a Drug Discount Card accepted at more than 63,000 pharmacies.
- The HealthWell Foundation provides financial assistance to cover drug copayments, deductibles, and other costs.
- The PAN Foundation helps cover out-of-pocket drug costs.
- Professional Prescription Advice connects consumers with programs to help pay for medication.
Some pharmaceutical companies also offer their own patient assistance or support programs to help cover the cost of their drugs:
- AbbVie (Mavyret)
- Gilead (Epclusa, Harvoni, Sovaldi, Vosevi)
- Johnson & Johnson Innovative Medicine (Olysio)
- Merck (Zepatier)
Many of these assistance programs or copay cards have set criteria for eligibility, so it’s important to read the fine print.
Some doctors’ offices have a dedicated staff member to help patients cover their medication costs. If you’re having difficulty paying for your hepatitis C drugs, ask your doctor for advice.