Mavyret, Epclusa, and Harvoni belong to a class of oral medications called direct-acting antivirals (DAAs) that cure chronic hepatitis C in the vast majority of patients. Mavyret (glecaprevir/pibrentasvir) is made by AbbVie and combines an NS3/4A protease inhibitor with an NS5A inhibitor; it treats all six hepatitis C genotypes in as little as 8 weeks. Epclusa (sofosbuvir/velpatasvir) and Harvoni (ledipasvir/sofosbuvir) are both made by Gilead Sciences and pair an NS5B polymerase inhibitor with an NS5A inhibitor; Epclusa covers all genotypes, while Harvoni is approved mainly for genotypes 1, 4, 5, and 6. These drugs replaced older interferon-based regimens that took up to a year and caused severe side effects. Cure rates for all three regimens exceed 95% when the full course is completed.
AbbVie and Gilead set high list prices for these regimens when they launched between 2014 and 2017, and both manufacturers still publish high sticker prices in 2026 even though almost no one pays them in full. Mavyret's list price of $26,400 for a full course positioned it as the value option when AbbVie launched it in 2017, undercutting Harvoni's original $94,500 list price. Gilead responded by creating Asegua Therapeutics, a subsidiary that sells authorized generic versions of Epclusa and Harvoni at about $24,000 per course, roughly a third of the brand price. Insurers, Medicaid programs, and the federal government negotiate confidential rebates that push net prices well below the list prices quoted here, but the sticker price is still what shows up on an uninsured patient's bill or an insurer's explanation of benefits before rebates apply.
Medicaid programs restricted hepatitis C treatment heavily in the years after these drugs launched, often requiring patients to reach advanced liver scarring (fibrosis stage F3 or F4) or prove months of sobriety before approving coverage. CMS notified states in 2015 that fibrosis-stage and sobriety restrictions violate federal Medicaid law, and by 2025 at least 34 states and Washington, D.C. had dropped prior authorization requirements for a patient's first hepatitis C treatment course. State report cards published by patient advocacy groups now grade every state on Medicaid access, and more than two-thirds earned an A or A+ grade heading into 2026. Coverage still varies by state and by managed-care plan, so check your state's current Medicaid hepatitis C policy and household Medicaid income limits before assuming you will face a denial. Patients who are incarcerated or recently released also face separate access rules; correctional systems in several states have been sued for refusing to treat hepatitis C despite the drugs being covered under state Medicaid.
What Hep C Treatment Costs by Point of Pay (2026)
The price you pay depends almost entirely on WHERE you pay. The same hep c treatment can cost many times more at a hospital than at your local pharmacy:
2026 Hep C Treatment Price by Point of Pay| Where you pay | Typical cost | Notes |
|---|
| Pharmacy counter (retail, cash) | $26,400 - $94,500 per full course | Full 8 to 12 week course list price in 2026. Mavyret is cheapest; brand Harvoni is priciest. |
| Medicare Part D (2026) | $0 - $2,100 total for the year | One fill often reaches the entire annual Part D out-of-pocket cap immediately. |
| Commercial insurance | $0 - $500 per course after prior authorization | Usually placed on the highest specialty formulary tier; prior authorization is standard. |
| Manufacturer PAP (myAbbVie Assist / Gilead Support Path) | $0 for eligible patients | Available up to 600% FPL for uninsured or underinsured patients. |
| Medicaid | $1 - $4 per prescription | Most states removed fibrosis-stage and sobriety restrictions after 2015 CMS guidance. |
Retail prices reflect 2026 list prices and GoodRx/specialty-pharmacy survey data. Commercial and Medicaid ranges depend on your plan's formulary tier and prior authorization outcome.
Source: AbbVie and Gilead list pricing, CMS Medicare Part D 2026 benefit design, state Medicaid hepatitis C policies, GoodRx
Why Hospitals Charge So Much
Hospitals rarely administer Mavyret, Epclusa, or Harvoni directly because all three are oral tablets a patient takes at home for 8 to 12 weeks, dispensed through a specialty pharmacy rather than an inpatient pharmacy. Correctional facilities and hospital-based liver clinics are the main exception: state prison systems and hospital outpatient clinics sometimes bill a partial course at facility rates that include markups for pharmacy handling, nursing counseling visits, and specialty drug storage. A facility that bills $35,000 to $140,000 for a course that lists at $26,400 to $94,500 wholesale is applying standard hospital chargemaster markups on top of the drug's acquisition cost. Prison systems have faced lawsuits, including in Massachusetts, Florida, and Tennessee, for refusing hepatitis C treatment on cost grounds, and courts have generally ruled that failing to treat chronic hepatitis C in custody violates the Eighth Amendment.
Patients who receive treatment through a hospital-affiliated specialty pharmacy instead of a retail or mail-order specialty pharmacy should ask for the National Drug Code (NDC) on every bottle dispensed and confirm whether the hospital billed the brand product or the lower-cost authorized generic. A hospital system that automatically dispenses brand-name Harvoni at $94,500 when the authorized generic version costs about $24,000 for the same course is leaving significant savings on the table. Ask the hospital's financial counselor whether the facility participates in the 340B Drug Pricing Program, which lets qualifying safety-net hospitals acquire these drugs at steep discounts that should be reflected in a self-pay patient's bill. If your itemized bill shows a per-tablet or per-fill charge far above the wholesale acquisition cost, request an itemized statement and dispute the markup directly with the hospital's billing department or through your state's balance-billing protections.
Patient Assistance Programs
AbbVie (Mavyret) and Gilead Sciences (Epclusa, Harvoni, Vosevi, Sovaldi) each run a patient assistance program that supplies the medication free of charge to eligible patients, regardless of the retail sticker price. Eligibility is unusually generous for a manufacturer PAP: both programs accept applicants earning up to 600% of the [federal poverty level](/en/federal-poverty-level), roughly $95,760 for a single person in 2026, reflecting how expensive these drugs are relative to typical household income.
Patient assistance programs for Hep C Treatment| Manufacturer program | Cost / Benefit | How to apply |
|---|
| myAbbVie Assist (Mavyret) | Free Mavyret for uninsured patients and Medicare Part D patients without Low-Income Subsidy, income up to 600% FPL | abbvie.com/patients |
| Gilead Support Path / Advancing Access (Epclusa, Harvoni, Vosevi, Sovaldi) | Free medication for uninsured patients up to 600% FPL; as little as $5 copay for eligible commercially-insured patients | mysupportpath.com |
| NeedyMeds Hepatitis C Drug Discount Card | Variable discount accepted at most US pharmacies, including specialty pharmacy networks | needymeds.org |
Manufacturer copay cards and coupons generally cannot be used by anyone enrolled in Medicare, Medicaid, TRICARE, or VA benefits under the federal anti-kickback statute (42 U.S.C. Section 1320a-7b). If you have government insurance, apply for myAbbVie Assist or Gilead Support Path directly instead of looking for a manufacturer coupon; both programs are structured to serve Medicare Part D patients who lack the Low-Income Subsidy.
Source: AbbVie myAbbVie Assist, Gilead Support Path / Advancing Access, NeedyMeds.org
Medicare Part D
Medicare Part D covers Mavyret, Epclusa, and Harvoni for patients diagnosed with chronic hepatitis C, and most Part D formularies place all three on the highest specialty tier. For 2026, the total amount a beneficiary pays out-of-pocket across every Part D drug combined is capped at $2,100 for the year under the Inflation Reduction Act. Because a single 28-day fill of any of these drugs carries a list price between $12,900 and $31,500, most Medicare patients who fill one bottle in January will hit the entire $2,100 cap with that single fill and pay $0 for every other Part D prescription for the rest of the year. Confirm your specific Medicare eligibility and Part D enrollment status before starting treatment, since a lapse in coverage during your 8 to 12 week course can leave you paying full price for a later fill.
Prior authorization is standard for all three drugs on Medicare Part D plans, and the prescriber typically must confirm the hepatitis C genotype, prior treatment history, and liver fibrosis stage before the plan approves the fill. Medicare does not impose the fibrosis-stage restrictions that some state Medicaid programs used to require, so a Part D denial based solely on liver damage severity can usually be appealed successfully by citing current AASLD/IDSA treatment guidelines. Beneficiaries can also enroll in the Medicare Prescription Payment Plan, which spreads the $2,100 out-of-pocket cap across monthly installments instead of one large upfront charge for the first fill. Ask your Part D plan to enroll you in this payment plan before you fill the prescription if a single upfront charge near $2,100 would create a hardship.
Common Hep C Treatment Billing Errors
If your bill for Mavyret, Epclusa, or Harvoni looks higher than the ranges above, check for these common errors before paying:
- Brand-name Harvoni or Epclusa dispensed and billed when the authorized generic (ledipasvir/sofosbuvir or sofosbuvir/velpatasvir from Asegua Therapeutics) would have cost roughly a third as much for the same course.
- Each 28-day fill billed as a separate prior authorization and separate copay, when your plan should treat the full 8 to 12 week course as a single approved treatment episode.
- Medicaid denial citing a fibrosis stage (F0-F2) requirement or a sobriety requirement, both of which CMS determined in 2015 violate federal Medicaid access rules for most states.
- Genotype testing or liver fibrosis staging billed separately at full charge instead of being bundled into the pre-treatment workup covered by your plan.
- Charged Part D cost-sharing after you already reached the $2,100 annual out-of-pocket cap for the year.
- Correctional-facility or hospital-affiliated specialty pharmacy billing at a facility markup rate several times the wholesale acquisition cost.
Frequently Asked Questions
Is there a generic for Mavyret, Epclusa, or Harvoni?
Yes, for two of the three. Gilead's Asegua Therapeutics subsidiary sells FDA-approved authorized generic versions of Epclusa (sofosbuvir/velpatasvir) and Harvoni (ledipasvir/sofosbuvir), each priced around $24,000 for a full course, about a third of the brand price. No generic version of Mavyret (glecaprevir/pibrentasvir) exists as of 2026; AbbVie's patents are not expected to clear until the early 2030s. These are small-molecule antivirals, not biologics, so there is no biosimilar pathway the way there is for insulin or Humira.
How do I apply for the AbbVie or Gilead patient assistance program?
Call AbbVie at 1-800-222-6885 for Mavyret or Gilead Support Path at 1-855-769-7284 for Epclusa or Harvoni, or apply online at abbvie.com/patients or mysupportpath.com. Have your prescriber confirm your hepatitis C diagnosis and genotype, then submit proof of income, proof of US residency, your prescription, and your insurance status. Both programs typically decide within 3 to 5 business days and ship the medication directly to you or your prescriber's office once approved.
Can I use a Mavyret, Epclusa, or Harvoni manufacturer coupon with Medicare?
No. Federal anti-kickback law bars manufacturer copay cards and coupons from being used by anyone on Medicare, Medicaid, TRICARE, or VA benefits. AbbVie and Gilead do not offer traditional commercial coupons for these drugs anyway; instead, both route assistance through myAbbVie Assist and Gilead Support Path, which are specifically structured to help Medicare Part D patients who lack the Low-Income Subsidy and can supply the medication free of charge.
What if my insurance or Medicaid denies coverage for Hep C treatment?
Request the written denial notice, then file a formal appeal within your plan's deadline (60 days for Medicare Part D) with a letter of medical necessity from your prescriber. If the denial cites liver fibrosis stage or a sobriety requirement, ask your prescriber to cite the 2015 CMS guidance that bars most states from using those restrictions. If the appeal stalls, apply to myAbbVie Assist or Gilead Support Path while you wait; neither requires a final coverage decision first.
Does the IRA negotiated price apply to Hep C treatment in 2026?
No. Mavyret, Epclusa, and Harvoni are not among the drugs CMS has selected for Inflation Reduction Act price negotiation, so there is no Medicare Maximum Fair Price for any of them in 2026. Medicare Part D patients instead benefit from the general $2,100 annual out-of-pocket cap; because a single fill of any of these drugs often costs more than that, most patients hit the entire cap with their first fill and pay $0 for the rest of the year.
What does Hep C treatment cost without insurance at the pharmacy in 2026?
Mavyret's full 8-week course lists at $26,400 in 2026, with a single 28-day fill running $12,877 to $14,581 depending on the pharmacy. Epclusa's brand course runs about $74,760 and Harvoni's brand course can reach $94,500, though authorized generic versions of both cost roughly $24,000 for a full course. Almost no cash-paying patient pays these full amounts; myAbbVie Assist and Gilead Support Path can supply any of the three free of charge for eligible income levels.
Do I qualify for the AbbVie or Gilead patient assistance program?
You likely qualify if you are uninsured, or if you have Medicare Part D without the Low-Income Subsidy, and your household income is at or below 600% of the federal poverty level, about $95,760 for a single person or $198,000 for a family of four in 2026. You generally do not qualify if you already have Medicaid, since Medicaid covers these drugs directly in nearly every state. You also need a valid prescription and proof of US residency.
What is the difference between Mavyret, Epclusa, and Harvoni?
Mavyret (AbbVie) treats all six hepatitis C genotypes in as little as 8 weeks and lists at $26,400 per course, the cheapest of the three. Epclusa (Gilead) also covers all genotypes over a typical 12-week course and lists near $74,760. Harvoni (Gilead) is approved mainly for genotypes 1, 4, 5, and 6 over 8 to 12 weeks and lists as high as $94,500. Your prescriber chooses based on your genotype, liver fibrosis stage, and treatment history, not just cost.
