Hepatitis C is a disease of the liver caused by the hepatitis C virus (HCV). Its effects can range from mild to serious. Without treatment, chronic hepatitis C can lead to severe liver scarring, and possibly to liver failure or cancer.
About 3 million people in the United States live with chronic hepatitis C. Most of them don't feel ill or know that they've contracted the disease.
Years ago, people with hepatitis C essentially had 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 they're much more effective than older treatments. These drugs cure more than 90 percent of people who take them in just 8 to 12 weeks, with fewer side effects than older drugs.
The one downside to new hepatitis C treatments is they come with a steep price tag. Read on to learn about the high costs of hepatitis C drugs, and how to cover them.
1. You have more treatment options than ever before
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 and 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:
- your virus genotype
- the extent of your liver damage
- which other treatments you've had in the past
- what other medical conditions you have
2. Hepatitis C drugs are pricey
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:
- Harvoni costs $94,500 for a 12-week treatment
- Mavyret costs $39,600 for a 12-week treatment
- Zepatier costs $54,600 for a 12-week treatment
- Technivie costs $76,653 for a 12-week treatment
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 run pharmaceutical companies nearly $900 million.
Another factor adding to the high cost is the lack of a national health care 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 essentially 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.
3. You may not need treatment
Not everyone with hepatitis C will need to receive these expensive treatments. In up to 25 percent of people with hepatitis C, the virus clears on its own within a few months without any need for medication. Your doctor will monitor you closely to see if your condition persists, and then decide if you need treatment.
4. Your insurance company could say no
Some insurance companies try to combat the high cost of hepatitis C drugs by rejecting coverage for them. More than one-third of people were denied coverage for these drugs by their insurance company, according to a 2018 study in Open Forum Infectious Diseases. Private insurance companies rejected more claims for these drugs — over 52 percent — 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
- showing proof that you have stopped using alcohol or illicit drugs, if this is a problem
5. Help is available
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:
- American Liver Foundation has partnered with NeedyMeds to create a Drug Discount Card that's accepted at more than 63,000 pharmacies.
- HealthWell Foundation provides financial assistance to cover drug copayments, deductibles, and other costs.
- PAN Foundation helps to cover out-of-pocket drug costs.
- Partnership for Prescription Assistance connects consumers with programs that can help them pay for their drugs.
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)
- Janssen (Olysio)
- Merck (Zepatier)
Some doctor's offices have a dedicated staff member available to help patients cover their medication costs. If you're having difficulty paying for your hepatitis C drugs, ask your doctor for advice.