Epclusa is sofosbuvir 400 mg combined with velpatasvir 100 mg, one tablet a day for 12 weeks, and it cures hepatitis C across all six genotypes. It is the closest thing this category has to a default regimen, which is why its price gets quoted so often and understood so rarely.
The thing to know before you read another number about it: Gilead sells the exact same tablet twice, at two very different prices, through two of its own entities. Understanding that single fact is worth about $50,000 on a course of treatment. Every figure below was verified on September 2, 2026.
What Does Epclusa Cost Without Insurance?
Three independent sources anchor the table. Gilead publishes its own list price (wholesale acquisition cost, or WAC). CMS publishes the National Average Drug Acquisition Cost (NADAC), the price retail pharmacies actually pay wholesale, refreshed weekly. SingleCare publishes live card and average retail cash prices by chain.
| Item | Low | Average | High |
|---|---|---|---|
| Brand Epclusa, one 28-tablet bottle | $24,259 | $24,920 | $35,442 |
| Brand Epclusa, full 12-week course | $72,778 | $74,760 | $106,327 |
| Authorized generic (Asegua), one 28-tablet pack | $7,785 | $7,826 | $8,839 |
| Authorized generic, full 12-week course | $23,356 | $23,478 | $26,517 |
| Commercially insured, per month | $5 | under $250 | under $250 |
| Medicare or Medicaid, per month | $0 | $0 | $5 |
| Uninsured through Support Path patient assistance | $0 | $0 | $0 |
Gilead’s own price information page states plainly that the list price of Epclusa is $24,920 per month, listed as of January 1, 2026, for a 28-day supply. NADAC had Epclusa at $866.39883 per tablet effective August 19, 2026, which works out to $24,259.17 per 28-tablet bottle, within 3% of list. SingleCare’s Epclusa page, updated September 2, 2026, reports an average retail cash price of $35,442.29 for that same bottle, roughly 42% above list, which is the high end of the range and a good illustration of why “average retail” is not the same thing as what the product costs.
The authorized generic row is the one that changes outcomes. NADAC lists sofosbuvir-velpatasvir 400-100 at $278.04918 per tablet effective August 19, 2026, which is $7,785.38 for a 28-tablet pack. SingleCare’s card price on the same product on the same day was $7,826.00 at Kroger and Harris Teeter, $8,168.00 at Food Lion, $8,212.00 at Walgreens, $8,264.00 at Publix and $8,839.00 at Costco. Two entirely separate pricing sources land within half a percent of each other at the bottom of that range, which is unusually tight agreement for a specialty drug.
Multiply by three bottles and the decision is stark: $23,356 to $26,517 for the authorized generic against $72,778 to $74,760 for the brand.
Why the same pill has two prices
In September 2018 Gilead announced it would launch authorized generics of both Epclusa and Harvoni in the United States through a newly created subsidiary, Asegua Therapeutics LLC, at a list price of $24,000 for the most common course of therapy, available from January 2019. Gilead’s stated reason was that the average price actually paid per bottle had already fallen more than 60% off list across insurers and government payers since 2013, but that “existing contracts, together with laws associated with government pricing policies, make it challenging to quickly lower a product’s list price once it is on the market.”
In other words, the authorized generic exists because Gilead could not easily cut the brand’s list price without disrupting the rebate contracts built on top of it. The company said openly that the generics were “priced to more closely reflect the discounts that health insurers and government payers receive today.”
Asegua’s own product page confirms what you are getting: the authorized generic of Epclusa is a 400/100 mg tablet in a 28-count blister pack under NDC 72626-2701-1, distributed through the same major wholesalers as the brand. Gilead’s Epclusa patient site describes it as having “the same exact ingredients as EPCLUSA,” working the same way with the same safety profile, “but comes in different packing.”
That NDC is the one CMS prices at $278.04918 per tablet. It is the number to ask for by name.
What Drives the Price
Brand versus authorized generic. This single choice moves the course total by roughly $50,000, and it is the only lever on this page that a cash payer controls outright. Ask the prescriber to write for the authorized generic and ask the pharmacy whether it stocks that NDC.
Course length. Twelve weeks is standard for most patients. Some patients with decompensated cirrhosis take Epclusa with ribavirin, and some retreatment scenarios use a different regimen entirely. Each additional bottle is another $7,785 to $24,920 depending on which version you are on.
Which pharmacy fills it. SingleCare’s own September 2026 data spans $7,826.00 to $8,839.00 per bottle for the authorized generic. Over three bottles that is a $3,039 difference for identical tablets.
Whether the claim runs through a plan at all. Gilead’s price page reports that a commercially insured patient typically pays less than $250 per month, that Medicare and Medicaid patients typically pay $0 to $5 per month, and that most Medicaid patients pay $0 for the full course based on 2025 Gilead Medicaid coverage data. None of those numbers are available to someone paying cash without first applying to assistance.
Whether you were screened for hepatitis B first. Both the brand and the authorized generic carry a boxed warning about hepatitis B virus reactivation, so a hepatitis B panel is part of the mandatory workup, not an upsell. Budget for it alongside the viral load test.
Cash Price vs. Insurance
For most drugs on this site, cash sometimes beats running the claim. On Epclusa it essentially never does, because both the insured and the uninsured routes end well below the cash price.
With commercial insurance, Gilead’s co-pay savings program can bring eligible patients to as little as $5 per month, and Gilead’s corporate access page confirms the same $5 figure for hepatitis C products generally. The program is not available to anyone enrolled in Medicare, Medicaid, TRICARE or VA coverage.
With Medicare Part D, the $2,000 annual out-of-pocket cap that took effect January 1, 2025 matters more here than almost anywhere else, because a single 12-week course used to push a patient through every coverage phase in one go.
Without insurance, the Support Path patient assistance program provides Gilead and Asegua hepatitis C medicines at no cost to patients who meet its eligibility criteria. Gilead lists Epclusa, Harvoni, Vosevi, Sovaldi and the Asegua authorized generics among the supported products. The program line is 1-855-769-7284, Monday through Friday, 9 a.m. to 8 p.m. Eastern.
Cash pricing is what you fall back to if you do not qualify, not where you should start.
How to Pay Less
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Call Support Path before you call a pharmacy. A qualifying uninsured patient pays nothing. The gap between that and the best cash price is more than $23,000, which makes the application the single highest-value hour you will spend on this.
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Ask for the authorized generic by NDC. “Sofosbuvir/velpatasvir 400/100 by Asegua, NDC 72626-2701-1” is unambiguous. A pharmacy that stocks brand Epclusa may not stock it, and vice versa.
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Price three pharmacies before transferring the prescription. The $7,826 to $8,839 per-bottle spread is real money over a full course, and it exists between chains in the same town.
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Get treated at a 340B covered entity if you can. Federally qualified health centers, Ryan White clinics and other safety-net providers buy outpatient drugs at statutorily discounted prices, and health centers must discount their own fees on a sliding scale. Our guide to free and sliding-scale clinics explains how to find one and what to bring.
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Separate the drug bill from the workup bill and shop each. The antibody test, viral load, hepatitis B panel and fibrosis assessment are billed independently of the medication. Our guide to blood work costs without insurance covers consumer lab menu pricing, and our hepatitis C treatment cost guide prices the full workup line by line.
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If a bill for the brand has already gone out, contest it before you pay it. A charge anywhere near $35,442 for one bottle is well above both list price and acquisition cost. Our guides to reading an itemized hospital bill and negotiating medical bills cover how to get the line detail and what to say. If it has already gone to a collector, see our guide to medical bills in collections.
Bottom Line
There are effectively four Epclusa prices in September 2026: $74,760 for a brand course at list, $23,356 for the authorized generic at acquisition cost, roughly $60 to $250 a month with commercial insurance and a co-pay card, and $0 through Support Path if you qualify. The tablets are identical.
If you are uninsured, work that list backwards. Apply for patient assistance first, ask about 340B pricing at a community health center second, and only price the authorized generic at retail if both of those fail. There is no version of this where paying $74,760 is the right answer.
For a comparison against Mavyret and the rest of the direct-acting antiviral shelf, plus the cost of the pre-treatment workup, see our hepatitis C treatment cost guide. If you are also managing HIV, our Biktarvy cost guide and PrEP cost guide cover that side. And to check a quote against typical cash rates, use our fair price checker.