Epclusa (sofosbuvir/velpatasvir) is the first FDA-approved hepatitis C treatment capable of curing all six major genotypes in a single 12-week course. Its clinical effectiveness is extraordinary — sustained virologic response (SVR) rates reach 95–99% across genotypes, which is the medical definition of a cure. The obstacle for most patients is not the medicine but its price: without insurance or assistance, a full 84-tablet course carries a list price approaching $75,000.
This page breaks down exactly what Epclusa costs in the USA in 2026 — brand vs. generic, with and without insurance — and explains every legitimate pathway to making this treatment accessible.
Sources: Gilead Sciences WAC (January 1, 2026); GoodRx (February 2026). List prices are not what most patients pay — see the insurance and assistance sections below.
What Is Epclusa?
Epclusa is a once-daily fixed-dose combination tablet containing sofosbuvir 400 mg and velpatasvir 100 mg. Manufactured by Gilead Sciences and FDA-approved on June 28, 2016, it belongs to a class of medicines called direct-acting antivirals (DAAs). Unlike older interferon-based regimens that caused significant side effects and had lower cure rates, Epclusa is taken orally for 12 weeks with high tolerability and pan-genotypic coverage.
- Treats all hepatitis C genotypes: 1, 2, 3, 4, 5, and 6
- Once-daily oral tablet — one pill per day for 84 consecutive days
- SVR (cure) rates of 95–99% across all genotypes in clinical trials
- Approved for adults and children aged 3 years and older (weighing ≥17 kg)
- Oral pellet formulation available for children who cannot swallow tablets
- Can be used with or without compensated cirrhosis (Child-Pugh A)
The authorized generic of Epclusa — sofosbuvir/velpatasvir 400 mg/100 mg — is manufactured by Asegua Therapeutics, a subsidiary of Gilead Sciences. It contains identical active ingredients, works the same way, and carries the same safety profile as the brand. For most patients seeking to reduce cost, the generic is the first option to explore.
Epclusa Cost in the USA: Brand vs. Generic
The price of Epclusa varies substantially depending on whether you purchase brand or authorized generic, and whether you use a discount program or insurance. The table below summarizes 2026 pricing at major reference points.
| Product | Supply | Price | Notes |
|---|---|---|---|
| Brand Epclusa | 28 tablets (1 month) | $24,920 | WAC as of Jan 1, 2026 (Gilead) |
| Brand Epclusa | 84 tablets (full course) | ~$74,760 | List price; few patients pay this |
| Generic (Asegua) | 84 tablets (full course) | ~$24,000 | Authorized generic list price |
| Generic + GoodRx | 28 tablets (1 month) | ~$7,683 | GoodRx coupon price, Feb 2026 |
| Brand + Copay Card | Per month | $5 | Commercially insured patients only |
| Medicare Part D | Full course | ≤$2,000 OOP | 2025 Part D cap; 80% pay ≤$15/month |
| Medicaid | Full course | $0 | Most Medicaid beneficiaries pay $0 |
Important context: Wholesale acquisition cost (WAC) is the manufacturer’s published reference price — it is rarely what patients actually pay. Insurance negotiated rates, co-pay assistance programs, and discount cards significantly reduce out-of-pocket costs for the majority of patients.
Epclusa Cost With Insurance
Commercial (Employer or Marketplace) Insurance
Epclusa and its authorized generic are covered by most commercial health insurance plans. Your actual cost depends on your plan’s formulary tier, deductible, and co-insurance structure. Most commercial plans require prior authorization — your prescribing physician must submit documentation confirming your hepatitis C diagnosis and genotype before the pharmacy can dispense the medication.
If you have commercial insurance, you are likely eligible for the Gilead Epclusa Co-pay Coupon Program through Support Path. This program can reduce your monthly cost to as little as $5, covering up to 25% of the catalog price for three bottles (a full course), valid for six months from first redemption.
Co-pay accumulator and maximizer programs: Some insurers operate programs that prevent manufacturer copay assistance from counting toward your deductible. If your plan includes this feature, Gilead may limit co-pay savings to $25 per claim. Call Support Path at 1-855-769-7284 to confirm your benefit level before filling your first prescription.
Medicare Part D and Medicare Advantage
Epclusa is covered by most Medicare Part D prescription drug plans and Medicare Advantage plans. A landmark 2025 policy change introduced a $2,000 annual out-of-pocket cap for Medicare Part D. According to Gilead Sciences, approximately 80% of Medicare patients pay $15 or less per month for Epclusa under Part D.
Medicare beneficiaries who qualify for Extra Help (the Low Income Subsidy) can reduce their cost further to between $4 and $9 per month. Note that the Gilead Co-pay Coupon is not valid for Medicare or Medicaid beneficiaries, but Gilead’s Support Path program offers alternative financial assistance pathways for government-insured patients.
Medicaid
Medicaid coverage for Epclusa is strong across most states. Gilead Sciences’ 2025 data indicates that most people with Medicaid coverage pay $0 for a full course of Epclusa or its authorized generic. Some state programs eliminate co-pays entirely. Contact your state Medicaid office or call Gilead’s Support Path at 1-855-769-7284 for state-specific guidance.
Epclusa Cost Without Insurance
Patients without any insurance face the highest sticker prices, but several programs exist specifically to provide uninsured patients with Epclusa at reduced or no cost. Do not pay the published list price before exhausting these options.
Do not pay list price: The brand-name WAC of ~$74,760 for a full course is a reference price, not a fixed cash price. Uninsured patients have multiple pathways — including free medication through patient assistance programs — that should be explored before paying out of pocket.
- Gilead Support Path Patient Assistance Program: Provides Epclusa or the authorized generic at no cost to eligible uninsured patients who meet income criteria. Apply at MySupportPath.com or call 1-855-769-7284.
- GoodRx coupon (generic): Reduces the 28-day supply of generic sofosbuvir/velpatasvir to approximately $7,683 at participating pharmacies — no insurance required. A full 12-week course would cost roughly $23,000 using this approach.
- AIDS Drug Assistance Program (ADAP): Patients with concurrent HIV/HCV co-infection may qualify for Epclusa through state ADAP programs. Contact your state health department for enrollment details.
- Federally Qualified Health Centers (FQHCs): Community health centers participating in the 340B Drug Pricing Program can access Epclusa at substantially reduced cost. Use the HRSA finder at findahealthcenter.hrsa.gov to locate a center near you.
- ACA Marketplace enrollment: For patients without employer coverage, enrolling in a Marketplace plan — especially with income-based premium subsidies — may make Epclusa coverage accessible at low monthly premiums. Visit healthcare.gov to check your options.
How to Reduce Your Epclusa Cost: Step-by-Step
The right pathway to affordable Epclusa treatment depends on your insurance status. The guidance below covers each scenario.
If You Have Commercial Insurance
Request prior authorization through your prescribing doctor before filling your prescription. Once approved, visit MySupportPath.com or call 1-855-769-7284 to enroll in the Epclusa Co-pay Coupon Program. Eligible patients can reduce their monthly cost to $5. If your insurer uses a co-pay accumulator program, confirm your adjusted benefit amount with Gilead before filling.
If You Have Medicare
Check whether your Part D or Medicare Advantage plan covers Epclusa on its formulary. Your maximum out-of-pocket cost for covered medications under Part D is $2,000 in 2025. If you have limited income, apply for Medicare Extra Help at ssa.gov/extrahelp, which can reduce monthly costs to $4–$9. Gilead’s Support Path team can help navigate Medicare-specific options — call 1-855-769-7284.
If You Have Medicaid
Confirm that your state Medicaid plan covers Epclusa (most do). Most Medicaid beneficiaries pay $0. If your state plan does not cover Epclusa, contact Gilead’s Support Path program to explore alternatives, including the Patient Assistance Program.
If You Are Uninsured
Apply immediately for the Gilead Support Path Patient Assistance Program at MySupportPath.com. If you do not meet income eligibility criteria, use a GoodRx coupon for the authorized generic, or contact an FQHC community health center about 340B pricing in your area.
“The list price of EPCLUSA is $24,920 per month. The list price is not typically the price a patient pays. Typically a person taking EPCLUSA pays between $0 and $5 per month.” — Gilead Sciences, gileadpriceinfo.com (January 2026)
Gilead Support Path: Patient Assistance Program
The Gilead Support Path program is the primary financial assistance resource for patients who cannot afford Epclusa. It operates two distinct pathways based on insurance status.
| Program | Who Qualifies | Benefit | How to Apply |
|---|---|---|---|
| Co-pay Coupon | Commercially insured (not Medicare/Medicaid) | As low as $5/month | MySupportPath.com or 1-855-769-7284 |
| Patient Assistance | Uninsured or underinsured; meets income criteria | Free medication | MySupportPath.com or 1-855-769-7284 |
Support Path specialists are available Monday through Friday, 9 AM to 8 PM ET. They can conduct a benefits investigation, verify insurance coverage, and guide patients through enrollment. Apply online at MySupportPath.com.
Epclusa vs. Alternative Hepatitis C Treatments
Epclusa is not the only direct-acting antiviral approved for chronic hepatitis C. The most commonly prescribed alternatives are Mavyret (glecaprevir/pibrentasvir) from AbbVie and Harvoni (ledipasvir/sofosbuvir) from Gilead. Understanding how they compare can support a more informed conversation with your physician about the best option for your genotype and financial situation.
| Medication | Genotypes | Duration | List Price (Full Course) |
|---|---|---|---|
| Epclusa (sofosbuvir/velpatasvir) | 1, 2, 3, 4, 5, 6 | 12 weeks | ~$74,760 |
| Mavyret (glecaprevir/pibrentasvir) | 1, 2, 3, 4, 5, 6 | 8–12 weeks | ~$22,000–$36,000 |
| Harvoni (ledipasvir/sofosbuvir) | 1, 4, 5, 6 | 8–12 weeks | ~$94,000 |
Note: List price comparisons can be misleading because insurance negotiated rates, prior authorization requirements, and manufacturer assistance programs differ significantly by payer and plan. The clinical choice between these treatments depends on your specific genotype, cirrhosis status, and prior treatment history — always discuss alternatives with your prescribing physician.
Frequently Asked Questions
Without insurance, the brand-name list price for Epclusa is approximately $74,760 for a full 12-week course (84 tablets), based on the wholesale acquisition cost of $24,920 per 28-tablet supply as of January 1, 2026. The authorized generic (sofosbuvir/velpatasvir from Asegua Therapeutics) has a list price of roughly $24,000 for 84 tablets. Discount programs such as GoodRx can reduce the generic cost to approximately $7,683 for a 28-day supply.
Yes. Asegua Therapeutics, a subsidiary of Gilead Sciences, launched an authorized generic of Epclusa (sofosbuvir 400 mg/velpatasvir 100 mg) in 2019. It contains the identical active ingredients, works the same way, and has the same safety profile as the brand-name product. The list price is approximately $24,000 for 84 tablets; however, with GoodRx or similar discount programs, the cost for a 28-day supply can drop to around $7,683.
Epclusa is covered by most Medicare Part D and Medicare Advantage plans. As of 2025, Medicare Part D introduced a $2,000 annual out-of-pocket cap, which significantly limits what Medicare patients pay for high-cost specialty drugs like Epclusa. According to Gilead Sciences, approximately 80% of Medicare patients pay $15 or less for Epclusa. Note that the Gilead co-pay coupon card is not valid for Medicare or Medicaid beneficiaries; however, Gilead’s Support Path patient assistance program may provide alternative help.
Most Medicaid plans cover Epclusa or its authorized generic. According to Gilead Sciences’ 2025 data, most people with Medicaid coverage pay $0 for a full course of Epclusa or its authorized generic. Some state Medicaid programs eliminate co-pays altogether. Coverage may vary by state; contact your state Medicaid office or Gilead’s Support Path program for details specific to your plan.
The Gilead Support Path program provides financial assistance for patients who cannot afford Epclusa. For commercially insured patients, the co-pay coupon can reduce monthly costs to as little as $5. For uninsured or underinsured patients, the Support Path Patient Assistance Program may provide Epclusa at no cost or reduced cost. To apply, call 1-855-769-7284 or visit MySupportPath.com.
Commercially insured patients (employer-sponsored or marketplace insurance — not Medicare or Medicaid) may be eligible for the Epclusa Co-pay Coupon Program offered by Gilead through Support Path. Eligible patients can pay as little as $5 per month. The coupon covers up to 25% of the catalog price for three bottles, valid for 6 months from first redemption. Apply online at MySupportPath.com or call 1-855-769-7284.
Epclusa is a pan-genotypic treatment approved to treat all six major hepatitis C genotypes: 1, 2, 3, 4, 5, and 6. It is indicated for adults and children aged 3 years and older who weigh at least 17 kg (37 lbs), with or without compensated cirrhosis. Children who cannot swallow tablets may use Epclusa oral pellets at weight-appropriate doses.
References
- Gilead Sciences. gileadpriceinfo.com — EPCLUSA Cost Information. Wholesale Acquisition Cost as of January 1, 2026.
- GoodRx. goodrx.com — Epclusa 2026 Prices, Coupons & Savings Tips. Updated February 2026.
- Drugs.com. drugs.com — Epclusa Prices, Coupons, Copay Cards & Patient Assistance. Accessed March 2026.
- SingleCare. singlecare.com — How Much Is Epclusa Without Insurance?
- Gilead Sciences. epclusa.com — Save on the Cost of EPCLUSA. Based on 2025 Medicaid patient coverage data.
- GoodRx Health. goodrx.com — Epclusa Medicare Coverage and Co-Pay Details. Updated October 2025.
- GoodRx Health. goodrx.com — How Much Does Hepatitis C Treatment Cost With and Without Insurance?
- Drugs.com. drugs.com — How Much Does Epclusa Cost? Updated June 2025.
- SaveHealth. savehealth.com — Epclusa Coupons: Prices from $7,801 — March 2026.
- Gilead Sciences. epclusa.com — EPCLUSA Co-pay Coupon Eligibility. Updated November 2025.