Epclusa and Mavyret are the two most-prescribed hepatitis C cures in the US, and for most patients they are clinically about equal — both cure more than 95 percent of people across all genotypes. The real difference is cost and access: Mavyret has a lower list price and a shorter course, while Epclusa has an authorized generic that Mavyret lacks. SunnyPharma compiled this comparison to explain what each actually costs and how either one reaches $0.
The honest bottom line up front: the clinical choice between these two drugs belongs to your physician, who weighs your genotype, cirrhosis status, prior treatment, and other medications. The question you can control is what you will pay — and for both drugs, the answer for most patients is $0 through the right pathway. This guide covers verified US pricing for each, the generic difference, how treatment length differs, and every assistance route that brings the real cost to nothing.
This page is part of SunnyPharma’s complete guide to HCV medications, costs, and patient assistance. See also what Epclusa costs in the USA, or use the hepatitis C treatment access screener to find your $0 or low-cost pathway for either drug.
Is Epclusa or Mavyret better?
For the large majority of patients, neither drug is meaningfully better than the other. Both Epclusa (sofosbuvir/velpatasvir) and Mavyret (glecaprevir/pibrentasvir) are pan-genotypic direct-acting antivirals, meaning they treat all hepatitis C genotypes 1 through 6, and both achieve cure — defined as sustained virologic response, or SVR — in more than 95 percent of people treated. Large clinical trial programs put both in the same high-efficacy tier for typical patients.
Where a clinician may prefer one over the other comes down to specifics: genotype in combination with cirrhosis status, whether you have been treated before, and potential interactions with your other medications. In certain harder-to-treat situations a specialist may favor one regimen, but for a previously untreated patient without advanced liver disease, the two are generally interchangeable on medical grounds. That is why, for most people, the decision that actually shapes your experience is not which drug — it is what you will pay and how long you will be on treatment.
Epclusa vs Mavyret: side-by-side comparison
| Feature | Epclusa | Mavyret |
|---|---|---|
| Active ingredients | Sofosbuvir / velpatasvir | Glecaprevir / pibrentasvir |
| Manufacturer | Gilead Sciences | AbbVie |
| Genotypes treated | All (1–6) | All (1–6) |
| Typical course length | 12 weeks | 8 weeks (often); 12–16 in some cases |
| Cure rate (SVR) | >95% (~98–99% general population) | >95% |
| US list price | ~$74,760 / course | ~$26,400 / 8-week course |
| Authorized generic | Yes (~$24,000) | No |
| Ages | 3+ (weight-based) | 3+ |
| Path to $0 | Support Path, Medicaid, Medicare cap, ADAP, 340B, foundations | AbbVie PAP/copay, Medicaid, Medicare cap, ADAP, 340B, foundations |
List prices are 2026 manufacturer wholesale acquisition cost (WAC) reference points, not what patients pay. Course length and regimen are determined by your physician based on genotype, cirrhosis, and prior treatment.
Which costs less, Epclusa or Mavyret?
By sticker price, Mavyret is the lower-cost brand: roughly $26,400 for a standard 8-week course, compared with about $74,760 for a 12-week course of brand Epclusa. On list price alone, Mavyret has long been the cheaper brand-name cure. But that comparison is incomplete, because Epclusa has an authorized generic (sofosbuvir/velpatasvir) priced near $24,000 — which actually undercuts brand Mavyret. Mavyret, as of 2026, has no generic at all.
More importantly, list price is rarely what anyone pays. Both drugs reach $0 for patients who qualify for assistance, and a capped, predictable amount for most insured patients. So while the list-price question has a clear answer on paper, it seldom determines your real cost. The practical cost question is not “which drug is cheaper” but “which pathway brings my prescribed drug to $0” — and that pathway exists for both.
The one real difference: Epclusa has a generic, Mavyret does not
If there is a single practical distinction that matters for cost-burdened patients, it is this. Epclusa has an authorized generic, which gives payers, Medicaid programs, and cash-pay patients a substantially lower-priced option — and it is why several state Medicaid hepatitis C programs use authorized generic Epclusa as their preferred agent. Mavyret has no generic equivalent, so every Mavyret prescription is the brand. This does not make Mavyret unaffordable — its assistance programs are robust — but it does mean the generic-driven price floor that exists for Epclusa has no Mavyret counterpart.
How treatment length differs
Mavyret is frequently an 8-week course for patients without cirrhosis who have not been treated before, which is shorter than Epclusa’s standard 12 weeks. A shorter course can mean fewer pharmacy fills and less time managing therapy. In other situations — certain prior-treatment or cirrhosis scenarios — Mavyret extends to 12 or 16 weeks, and Epclusa remains 12 weeks for nearly everyone. Duration is a genuine day-to-day difference, but it does not change the near-universal cure rate of either drug, and your physician sets the length based on your clinical picture.
How to get either drug at $0
The most important thing to understand is that neither the higher list price of Epclusa nor the lack of a Mavyret generic should stop you from being treated. Both manufacturers, together with public programs, make a $0 or near-$0 path available to most patients. The routes are parallel:
1. Manufacturer patient assistance and copay programs
For Epclusa, Gilead Support Path provides the drug at no cost to eligible uninsured patients who meet income criteria, and a copay coupon that can bring commercially insured patients to as little as $5 per month. For Mavyret, AbbVie runs an equivalent patient assistance program for uninsured patients and a copay savings card for the commercially insured. In both cases, a hepatology clinic’s social work team can help with the application, and approval often comes within days.
2. Medicaid and Medicare
State Medicaid programs cover hepatitis C treatment, and most cover both drugs, frequently at $0 to the patient — several states use authorized generic Epclusa as their preferred agent, but Mavyret is widely covered as well. For Medicare beneficiaries, the Part D out-of-pocket cap now limits annual prescription costs, so most Medicare patients pay a predictable, bounded amount for either drug rather than the full price.
3. ADAP, 340B clinics, and foundations
Patients co-infected with HIV may qualify for hepatitis C treatment through state AIDS Drug Assistance Programs (ADAP) — a route specific to people living with HIV, not a general pathway. Federally Qualified Health Centers and other 340B-eligible facilities can access both drugs at substantially reduced prices. And nonprofit copay foundations provide additional support for insured patients facing out-of-pocket costs. These routes apply to Epclusa and Mavyret alike.
Not sure which pathway fits you? Use the hepatitis C treatment access screener to find the $0 or low-cost route for whichever drug your doctor prescribes.
Should you buy either drug from abroad?
For most US patients, the answer is no — and the reasoning is the same for both drugs. Because US assistance pathways bring Epclusa and Mavyret to $0 for those who qualify, no imported price can beat “free,” once you account for shipping, customs, and facilitator costs. Mavyret’s lack of a generic means there is no low-cost imported Mavyret at all. And for Epclusa’s generic, an imported product priced far below its true all-in import cost is a counterfeit red flag, not a bargain. The safest, cheapest, and most reliable route to a cure for either drug runs through the US pathways above — exhaust them before considering travel or importation.
Frequently asked questions
Is Epclusa or Mavyret better?
For most people, neither is clearly better — both cure hepatitis C in more than 95 percent of patients across all genotypes. The right choice depends on your genotype, whether you have cirrhosis, prior treatment history, and other medications you take, which is a decision for your physician. For patients paying out of pocket, the practical difference is cost: Epclusa has an authorized generic and Mavyret does not.
Which costs less, Epclusa or Mavyret?
By US list price, Mavyret is lower — about $26,400 for an 8-week course versus roughly $74,760 for a 12-week course of brand Epclusa. But Epclusa has an authorized generic (sofosbuvir/velpatasvir) priced near $24,000, which narrows the gap. In practice, what you actually pay is usually $0 for either drug through the right assistance pathway, so list price rarely decides the real cost.
Does Mavyret have a generic?
No. As of 2026 there is no authorized or FDA-approved generic version of Mavyret (glecaprevir/pibrentasvir). Epclusa does have an authorized generic. This is the single biggest practical difference between the two drugs for patients concerned about cost.
How long is treatment with each drug?
Mavyret is often an 8-week course for patients without cirrhosis who have not been treated before, and 12 or 16 weeks in some situations. Epclusa is a 12-week course for nearly everyone. A shorter course can mean fewer copays and less time on therapy, though it does not change the near-universal cure rate for either drug.
Do Epclusa and Mavyret treat all genotypes?
Yes. Both are pan-genotypic, meaning they treat hepatitis C genotypes 1 through 6. This is why the choice between them rarely comes down to which virus you have, and more often to treatment duration, cirrhosis status, prior treatment, and cost.
Can I get Mavyret at no cost even though it has no generic?
Yes. The absence of a generic does not mean you pay full price. AbbVie runs a patient assistance program for uninsured patients who meet income criteria, and a copay savings program for commercially insured patients. Medicaid covers Mavyret, and most Medicare Part D patients pay a capped amount. The pathways to $0 exist for Mavyret just as they do for Epclusa.
Which drug is better if I have cirrhosis?
Both treat patients with compensated cirrhosis, and cure rates remain high. Regimen and duration can differ by cirrhosis status and prior treatment, and decompensated (advanced) cirrhosis changes the options for both drugs. This is exactly the kind of decision that belongs with your hepatologist, not a price comparison.
If they are clinically similar, how do I choose?
Let your physician choose the drug on clinical grounds — genotype, cirrhosis, prior treatment, drug interactions. Then focus your own energy on the cost side, where you have the most control: confirm which assistance pathway brings your specific drug to $0. For most patients the clinical choice and the $0 pathway both work out regardless of which drug is prescribed.
Is it cheaper to buy either drug from Mexico or India?
For most US patients, no — and it carries real risk. US assistance pathways bring both Epclusa and Mavyret to $0 for those who qualify, which is lower than any imported price after shipping and facilitator costs. Mexico is not a reliable low-cost source, and an imported generic priced far below its true all-in import cost is a counterfeit red flag. Exhaust the US $0 pathways first.
What are the assistance pathways for each drug?
Epclusa: Gilead Support Path (patient assistance and copay coupon), Medicaid, Medicare Part D cap, ADAP for HIV co-infection, 340B clinics, and nonprofit foundations. Mavyret: AbbVie patient assistance and copay card, plus the same Medicaid, Medicare, ADAP, 340B, and foundation routes. The hepatitis C treatment access screener can point you to the right one.
How we made this article:
Pricing and generic-availability facts are drawn from manufacturer wholesale acquisition cost references, FDA approval status, and public assistance-program terms; clinical statements reflect the pan-genotypic labeling and published trial cure rates for both regimens. Comparative framing is editorial; all clinical decisions belong with a treating physician. Figures are 2026 reference points and each pathway routes the reader to confirm current terms with the program.
Read our editorial policy →References
- U.S. Food & Drug Administration — approval status and labeling for Epclusa and Mavyret (pan-genotypic indications, generic availability).
- AASLD-IDSA HCV Guidance — recommended regimens, treatment duration, and genotype/cirrhosis considerations.
- Gilead Support Path — Epclusa patient assistance and copay program terms.
- AbbVie Patient Support — Mavyret patient assistance and copay savings program terms.
- Medicaid.gov — state hepatitis C treatment coverage and preferred-agent policies.
- Centers for Medicare & Medicaid Services — Medicare Part D out-of-pocket cap.
- HRSA Office of Pharmacy Affairs — 340B Drug Pricing Program.