Hepatitis C Medications: Costs, Side Effects, and More

Hepatitis C is an infection that affects the liver. It's caused by the hepatitis C virus (HCV). The goal of treatment is to prevent liver damage. Treatment also helps clear the virus from your body.

Traditional treatments are often long and drawn-out. They may also cause a number of side effects. Newer, more advanced drugs are coming to the market, though. They're expensive and may not be covered by your health insurance. For example, the price for a full course of treatment for some of these drugs is more than $90,000. However, these drugs reduce the length of treatment and have fewer side effects. They may also work better.

Read on to learn more about both tradition medications and newer drug options.

Interferon and pegylated interferon

How it works

Interferon works by stopping HCV from spreading. It also protects healthy cells from infection. Interferons include Intron A. Pegylated interferons have been altered to work longer than interferon. These drugs include Pegasys and PegIntron.

Costs

These drugs cost about $4,000 per month. You may need treatment for up to 11 months.

Side effects

• flu-like symptoms, such as a fever and body aches
• reduced platelets and white blood cell count (may cause anemia or more infections)
• loss of appetite
• nausea
• hair loss
• higher blood sugar levels
• insomnia, or trouble falling or staying asleep
• weight gain or weight loss
• fatigue
• mood issues such as anger, anxiety, suicidal thoughts, or depression
• changes in how your thyroid works
• slowed growth in children

These drugs may also cause more serious side effects. These include:

• autoimmune diseases such as Raynaud's syndrome and Stevens-Johnson syndrome
• higher blood pressure (may lead to a heart attack or stroke)
• changes in your vision
• liver or lung disease
• bowel or pancreas inflammation
• allergic reactions

Ribavirin

How it works

It isn't known exactly how ribavirin works to treat hepatitis C. It may interfere with processes that are important for HCV to replicate. Many people need combination treatment with both interferon and ribavirin.

Cost

Ribavirin costs about $160 per month. You may need treatment for up to 11 months.

Side effects

• birth defects if you take it during pregnancy

• slowed growth in children
• anemia, including a severe kind of anemia that affects people with heart disease
• rash
• wheezing and shortness of breath
• sore throat
• cough
• vision problems

Simepravir (Olysio)

How it works

Simepravir (Olysio) is a protease inhibitor. It's often used with interferon and ribavirin. This treatment is called triple therapy.

Protease is an enzyme that helps HCV replicate and spread in your body. Simepravir works by binding to protease. This blocks the virus from using the enzyme. Then it can't copy itself.

Cost

This drug can cost$66,000 to $132,000 for 12 to 24 weeks of treatment.

Side effects

• anemia
• diarrhea
• fatigue
• headaches
• nausea
• vomiting

Sofosbuvir (Sovaldi)

How it works

Sofosbuvir(Sovaldi) is a polymerase inhibitor. It works by stopping the virus from replicating. This effect eventually causes the virus to die off.

Cost

Sofosbuvir costs about $87,000 for 12 weeks of treatment.

Side effects

• fatigue
• headache
• trouble sleeping
• itching
• nausea
• diarrhea
• anemia
• reduced white blood cell levels (may result in more infections)

This drug can cause a slowed heart rate if it's taken with amiodarone. Talk to your doctor if you take amiodarone.

Sofosbuvir/Ledipasvir (Harvoni)

How it works

Sometimes sofosbuvir is used as a combination treatment with ledipasvir.Ledipasvir works by stopping the virus from making copies of itself. Harvoni is the brand-name version of sofosbuvir/ledipasvir.

Cost

Sofosbuvir/ledipasvir costs around $94,000 for 12 weeks of treatment.

Side effects

• headache
• fatigue
• weakness
• nausea

This drug can also cause a slowed heart rate if it's taken with amiodarone. Talk to your doctor if you take amiodarone.

Elbasvir/grazoprevir (Zepatier)

How it works

This drug is a combination of two drugs. Elbasvir works by stopping HCV from building up in your body. It also keeps the virus from making copies of itself. Grazoprevir likewise prevents HCV from building up in your body and replicating.

Cost

Elbasvir/grazoprevir costs around $54,600 for 12 to 16 weeks of treatment.

Side effects

This drug may cause liver problems. Your doctor will check how your liver is working during treatment. People with moderate to severe liver disease may not be able to take this drug. Other side effects include:

• fatigue
• headache
• upset stomach
• diarrhea

Viekira Pak

How it works

Viekira Pak is a combination of four drugs in a single form. These drugs are:

• ombitasvir: blocks the formation of a protein that the virus uses to copy itself
• paritaprevir: stops the virus from building the pieces to make more virus
• dasabuvir: prevents the building blocks of the virus from coming together
• ritonavir: makes the other drugs in the combination work better

Cost

Viekira Pak costs about $83,300 for a full treatment, which is 12 to 24 weeks.

Side effects

The more common side effects of this drug include:

• nausea
• itching
• insomnia
• weakness

Ombitasvir/paritaprevir/ritonavir (Technivie)

How it works

Ombitasvir/paritaprevir/ritonavir (Technivie) works in the same way that Viekira Pak does. It has the same drugs that are in Viekira Pak, minus dasabuvir. This drug must be used with ribavirin.

Cost

Ombitasvir/paritaprevir/ritonavir costs approximately $81,000 for 12 weeks of treatment.

Side effects

Like Viekira Pak, this drug may cause liver failure and the need for a liver transplant. These liver problems may be fatal. Your doctor will test your liver function during treatment with this drug.

The more common side effects of this drug when taken with ribavirin include:

• fatigue
• weakness
• nausea
• insomnia
• itching and other skin problems

Daclatasvir (Daklinza)

How it works

Daclatasvir (Daklinza) prevents the hepatitis C virus from replicating. It may also help prevent drug resistance. Preventing drug resistance is important so that your hepatitis C will be more likely to respond to drugs in the future if you have a relapse.

This drug is often combined with sofosbuvir.

Cost

Daclatasvir costs about $63,000 for 12 weeks of treatment.

Side effects

• fatigue
• headache
• nausea
• diarrhea

This drug can also slow your heart rate if you take it with amiodarone. Talk to your doctor if you take amiodarone.

Newer medications may work better to treat an HCV infection. The cost is a barrier for many people, though. Treatment can be expensive, especially because it's common to need more than one hepatitis C drug.

Because of the high costs, some health insurance companies may not pay for these drugs. Or they may offer coverage but with high copays. Some insurance companies may not pay for treatment until your HCV infection causes severe symptoms. Call your health insurance company to find out about your coverage.

As more treatments come to the market, the competition will likely drive prices down.

There are advantages and disadvantages for newer drugs to treat hepatitis C. Share all of your concerns about your treatment with your doctor. Work together to find the best treatment regimen for your HCV.