4 Tips for Affording Your Hepatitis C Medication

Medically Reviewed By William C. Lloyd III, MD, FACS
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The last few years have brought wonderful medical developments for the hepatitis C virus (HCV). Since 2013, pharmaceutical companies have manufactured a handful of new drugs. Previous medical treatments brought low success rates and harsh side effects. But these new drugs can effectively wipe out your HCV and they're easier to take and to stomach. It all sounds great until you see the price tag.

Treatment courses on these new medications range from 8 to 24 weeks. And most only involve you taking a single tablet orally each day. But the wholesale price per tablet can hit $1,000.

Here are four tips for affording treatment.

1. Discuss treatment options with your doctor.

The Food and Drug Administration (FDA) has approved drugs to treat people with all types of HCV. And your doctor will identify and prescribe the best medication available to treat you specifically. But you may have options.

Ask your doctor to explain every choice available to you, keeping both drug efficacy and price in mind. The price tag attached to a 24-week regimen on an expensive new drug could hit $189,000. A 12-week regimen combining the same drug with a cheaper and older drug, like ribavirin, could cost less than $95,500. Your doctor and the office staff will be very knowledgeable regarding the best strategies that will make your hep C treatment most affordable. Talking to your doctor will help you focus your research on relevant options and realistic steps to take.

2. Explore your insurance options.

The cost of these newer HCV medications has posed a problem for insurers, too. Both private insurers and federal programs like Medicaid are struggling to make these drugs affordable. But with an estimated 3 million Americans with HCV, demand for these medications is staggering.

To offset costs, some insurers are only covering these new medications if you meet additional requirements. For example, some state Medicaid programs limit access to the HCV drug, sofosbuvir (Sovaldi). They may restrict access based on your liver disease stage. Or based on your drug and alcohol history. Or plans may only allow certain specialists to write you a prescription. Researchers have questioned the legality of these limitations. If deemed unlawful, insurers may have to lift restrictions.

Stay apprised of changes to the Affordable Care Act (ACA) and your state's Medicaid program. If your state hasn't expanded Medicaid, it may still do so at any point in the future—barring drastic changes to the ACA itself. With Medicaid expansion, you may find yourself eligible for government care. If private insurance is your only option, explore a variety of plans and look out for changes in coverage.

3. Research Patient Assistance Programs.

Patient Assistance Programs (PAPs) may be your new best friends. There are PAPs out there catering to the uninsured, the underinsured, and those earning low incomes. So don't assume you won't qualify for help. For some programs, eligibility extends to people making up to 500% of the federal poverty level. In 2016, 500% of the poverty level came to a single person income of $59,400 for most U.S. residents.

Along with nonprofit organizations, most HCV drug manufacturers offer support programs of their own. Some, for example, provide copay coupons to patients in need of financial help. If you're unsure about your eligibility, start the application process.

4. Compare prices at your local pharmacies.

Being a smart consumer doesn’t stop at the grocery store checkout. Prices for medications vary from pharmacy to pharmacy. Search for free apps to download onto your phone that can help you locate stores selling your prescription at the best price. Unfortunately, it will still be years before patents on brand-name HCV pharmaceuticals expire. As a result, we can't expect generic versions of these drugs any time soon. But knowing these apps exist can turn you into a proactive healthcare consumer any time you need prescription medications. As a bonus, some apps also provide information about existing PAPs for selected drugs.

Between late 2013 and now, many drug companies have brought oral HCV medications to market. As the market becomes more competitive, prices should continue to drop. Depending on your condition status, your finances, and your insurance, you may be able to save some money by biding your time.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2021 Feb 3
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THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
  1. Barua S, et al. Restrictions for Medicaid Reimbursement of Sofosbuvir for the Treatment of Hepatitis C Virus Infection in the United States. Annals of Internal Medicine. 2015;163:215-223.
  2. Brennan T, Shrank W. New Expensive Treatments for Hepatitis C Infection. JAMA. 2014;312:593-594.
  3. Daclatasvir (Daklinza). HCV Medications. Hepatitis C Online. University of Washington. http://www.hepatitisc.uw.edu/page/treatment/drugs/daclatasvir
  4. Daklinza Prices, Coupons and Patient Assistance Programs. Price Guide. Drugs.com. https://www.drugs.com/price-guide/daklinza
  5. Elbasvir-Grazoprevir (Zepatier). HCV Medications. Hepatitis C Online. University of Washington. http://www.hepatitisc.uw.edu/page/treatment/drugs/elbasvir-grazoprevir
  6. Eligibility. Medicaid. The Centers for Medicare & Medicaid Services. https://www.medicaid.gov/medicaid/eligibility/index.html
  7. Epclusa Prices, Coupons and Patient Assistance Programs. Price Guide. Drugs.com. https://www.drugs.com/price-guide/epclusa
  8. Harvoni Prices, Coupons and Patient Assistance Programs. Price Guide. Drugs.com. https://www.drugs.com/price-guide/harvoni
  9. Hill A, Cooke G. Hepatitis C can be cured globally, but at what cost? Science. 2014;345:141-142.
  10. Ledipasvir-Sofosbuvir (Harvoni). HCV Medications. Hepatitis C Online. University of Washington. http://www.hepatitisc.uw.edu/page/treatment/drugs/ledipasvir-sofosbuvir
  11. Most patients with HCV cured with new drugs — but at what price? Digestive diseases. Clinical updates. For Medical Professionals. Mayo Clinic. http://www.mayoclinic.org/medical-professionals/clinical-updates/digestive-diseases/most-patients-with-hcv-cured-with-new-drugs-but-at-what-price
  12. Olysio Prices, Coupons and Patient Assistance Programs. Price Guide. Drugs.com. https://www.drugs.com/price-guide/olysio
  13. Ombitasvir-Paritaprevir-Ritonavir and Dasabuvir (Viekira Pak). HCV Medications. Hepatitis C Online. University of Washington. http://www.hepatitisc.uw.edu/page/treatment/drugs/3d
  14. Ombitasvir-Paritaprevir-Ritonavir (Technivie). HCV Medications. Hepatitis C Online. University of Washington.  http://www.hepatitisc.uw.edu/page/treatment/drugs/ombitasvir-paritaprevir-ritonavir
  15. Overview of Cost, Reimbursement, and Cost-Effectiveness Considerations for Hepatitis C Treatment Regimens. Cost, Reimbursement, and Cost-effectiveness. Contents. HCV Guidance: Recommendations for Testing, Managing, and Treating Hepatitis C. American Association for the Study of Liver Diseases. http://www.hcvguidelines.org/full-report/overview-cost-reimbursement-and-cost-effectiveness-considerations-hepatitis-c-treatment
  16. Simeprevir (Olysio). HCV Medications. Hepatitis C Online. University of Washington. http://www.hepatitisc.uw.edu/page/treatment/drugs/simeprevir-drug
  17. Sofosbuvir (Sovaldi). HCV Medications. Hepatitis C Online. University of Washington. http://www.hepatitisc.uw.edu/page/treatment/drugs/sofosbuvir-drug
  18. Sofosbuvir-Velpatasvir (Epclusa). HCV Medications. Hepatitis C Online. University of Washington. http://www.hepatitisc.uw.edu/page/treatment/drugs/epclusa
  19. Sovaldi Prices, Coupons and Patient Assistance Programs. Price Guide. Drugs.com. https://www.drugs.com/price-guide/sovaldi
  20. Technivie Prices, Coupons and Patient Assistance Programs. Price Guide. Drugs.com. https://www.drugs.com/price-guide/technivie
  21. U.S. Federal Poverty Guidelines Used to Determine Financial Eligibility for Certain Federal Programs. Poverty Guidelines 01/25/2016. Office for the Assistant Secretary for Planning and Evaluation. U.S. Department of Health & Human Services. https://aspe.hhs.gov/poverty-guidelines
  22. Zepatier Prices, Coupons and Patient Assistance Programs. Price Guide. Drugs.com. https://www.drugs.com/price-guide/zepatier