Epclusa Cost and Available Discounts in 2025
Epclusa, a brand-name prescription medication, is used for treating the hepatitis C virus in certain adults and children. Its generic version is velpatasvir/sofosbuvir.
The cost of Epclusa can vary significantly, influenced by several factors. These include the drug pricing benchmarks set by the manufacturer, such as Wholesale Acquisition Cost (WAC), Average Wholesale Price (AWP), and Average Manufacturer Price (AMP), plus discounts and rebates negotiated between manufacturers and insurers or pharmacy benefit managers (PBMs).
Your health insurance plan's formulary tier placement, copayment/coinsurance levels, and whether your plan covers Epclusa at all also impact the cost. Coverage details like prior authorizations or step therapy may also influence your out-of-pocket cost.
To find out what the cost of Epclusa will be specifically for you, it's essential to:
- Check your insurance plan’s formulary or drug list to see which tier Epclusa is assigned to. Tier price levels vary by plan.
- Review your health insurance benefits documents (Evidence of Coverage or member handbook) for copay or coinsurance information related to that tier.
- Contact your health insurer’s customer service directly to ask about your exact cost based on your coverage.
- Visit your plan’s online member portal or pharmacy benefits manager website to look up your medication and view estimated costs after applying your plan’s rules and discounts.
Because the negotiated prices and patient cost shares vary between insurance plans and pharmacy benefit programs, getting a precise out-of-pocket cost requires checking with your own insurance carrier or pharmacy benefits provider.
If you're uninsured, manufacturer patient assistance programs might be available to reduce the cost. For example, the Epclusa Co-pay Coupon Program is designed to help with costs.
To get specific information about the cost per pill or packet, it's advisable to consult with a pharmacist. For details about saving money on prescriptions, check out a specific article.
For personalized guidance about cost issues related to Epclusa, talk with your doctor or pharmacist. For more information about how Epclusa treats hepatitis C, see a specific article about Epclusa for hepatitis C.
It's worth noting that the difference in costs between brand-name and generic drugs is due to the research costs for brand-name drugs and the market competition for generics. Generics tend to cost less than brand-name drugs. Therefore, the cost of Epclusa without insurance is likely higher than the cost with insurance coverage.
For those seeking additional resources, websites like Medicine Assistance Tool and NeedyMeds provide information about drug assistance programs, ways to make the most of insurance coverage, and links to savings cards and other services.
Lastly, for information about Medicare coverage for drugs, see articles about Medicare Prescription Drug Plans, drug coupons and Medicare, and the Medicare drug list. Some insurance companies may require prior authorization before covering Epclusa.
In summary, understanding the cost of Epclusa requires a thorough examination of various factors. Consulting with a doctor, pharmacist, or insurance provider can provide the most accurate information for an individual's situation.
- In some cases, the high cost of brand-name drugs like Epclusa can be offset by patient assistance programs, such as the Epclusa Co-pay Coupon Program, intended to help those who are uninsured afford their medications.
- When discussing health-and-wellness and treatment options, it's important to consider not only the research costs that contribute to brand-name drug prices, but also the potential lower costs associated with generic alternatives like velpatasvir/sofosbuvir (the generic version of Epclusa).
