Hepatitis C is one of the few serious chronic infections that a course of pills reliably cures, usually in 8 to 12 weeks, with a single daily tablet and few side effects. It is also the category where the gap between what a drug lists for and what a person pays is widest in all of American medicine.
That gap is the whole story of this page. There are at least five different prices for the same cure depending on which door you walk through: the brand list price, the authorized generic, a cash discount card, a state Medicaid program, and a manufacturer patient assistance program that charges nothing at all. Below are the real 2026 numbers for each, plus the pre-treatment workup, which is the part nobody budgets for. All figures were verified on September 2, 2026.
What Does Hepatitis C Treatment Cost Without Insurance?
CMS publishes the National Average Drug Acquisition Cost (NADAC), which is what retail pharmacies actually pay for a drug. Gilead and AbbVie publish list prices (wholesale acquisition cost) on their own patient-facing sites. SingleCare publishes live cash and card prices by chain. Where those three disagree, the range below shows it.
| Item | Low | Average | High |
|---|---|---|---|
| Brand Epclusa, full 12-week course | $72,778 | $74,760 | $106,327 |
| Authorized generic sofosbuvir/velpatasvir, 12-week course | $23,356 | $23,478 | $26,517 |
| Mavyret, 8-week course | $25,691 | $26,400 | $33,756 |
| Mavyret, 12-week course | $38,537 | $39,600 | $50,634 |
| Full course through manufacturer patient assistance | $0 | $0 | $0 |
| Pre-treatment labs (antibody, HCV RNA, hepatitis B panel, liver panel) | $545 | $545 | $545 |
| FibroScan (liver elastography), cash | $232 | $242 | $299 |
The 12-week brand row comes from Gilead’s own price page, which states a list price of $24,920 per 28-day supply as of January 1, 2026, and from NADAC, which had Epclusa at $866.39883 per tablet effective August 19, 2026 ($24,259.17 per 28-tablet bottle). SingleCare’s Epclusa page, updated September 2, 2026, reports an average retail cash price of $35,442.29 for the same 28 tablets, which is the high end of the row and roughly 46% above list.
The authorized generic row is the one that matters for a cash payer. NADAC has sofosbuvir/velpatasvir 400-100 mg at $278.04918 per tablet effective August 19, 2026, or $7,785.38 per 28-tablet bottle and $23,356.13 for the full course. SingleCare’s card price on the same product is $7,826.00 per 28-tablet box at Kroger and Harris Teeter, rising to $8,839.00 at Costco, so $23,478 to $26,517 for 12 weeks. Two completely independent sources landing within half a percent of each other on the low end is unusually strong corroboration for a specialty drug.
Mavyret sits between the two. AbbVie’s cost page states a wholesale acquisition cost of $13,200.00 per month as of January 2025. NADAC has it at $152.92388 per tablet effective August 19, 2026, and the dose is three tablets daily, so an 84-tablet carton (28 days) is $12,845.61. SingleCare’s Mavyret page, updated September 2, 2026, lists an average retail cash price of $16,878.04 per 84-tablet box against a card price of $12,911.60. Because most patients complete Mavyret in 8 weeks rather than 12, the shorter course partly closes the gap against the authorized generic.
For context on the number as a whole, CDC published a study summary on May 13, 2026 putting the one-time cost of curative direct-acting antiviral treatment at approximately $25,000 and estimating that curing one person saves an average of $65,841 in lifetime medical costs (2022 dollars).
The pre-treatment workup
Before anyone writes a prescription, you need a confirmed active infection, a hepatitis B screen and a read on how much liver damage you already have. Priced at cash consumer rates on September 2, 2026:
- Hepatitis C antibody test with confirmation: $62.00 on Quest’s consumer menu. This tells you whether you have ever been infected, not whether you still are.
- Quantitative HCV RNA (viral load): $329.00 at Walk-In Lab, discounted to $279.65 during a promotion running through September 8, 2026. This is the test that confirms active infection.
- Hepatitis B panel: $99.00 at Quest. Not optional. Both Epclusa and Mavyret carry a warning about hepatitis B virus reactivation during or after treatment, and both labels direct providers to test for hepatitis B before starting.
- Comprehensive metabolic panel: $49.00 at Quest, covering the liver enzymes and other values that feed non-invasive fibrosis scores.
- Physician service fee: $6.00 per Quest order.
That is $545 in blood work. Fibrosis staging adds a FibroScan (transient elastography), which MDsave prices at $232 to $253 with a $242 platform national average against a $412 estimated national average, and which American Health Imaging sells self-pay at $299 with a doctor’s referral.
Genotype testing, which used to be a mandatory and expensive step, is largely obsolete. Epclusa is labeled for hepatitis C genotypes 1 through 6 and Mavyret for genotypes 1 through 6, so the regimen choice no longer usually turns on the answer. Ask before you pay for it.
What Drives the Price
Brand versus authorized generic. This is a roughly $50,000 decision on one drug. Gilead launched authorized generics of Epclusa and Harvoni through its subsidiary Asegua Therapeutics at a list price of $24,000 for the most common course of therapy, available from January 2019. Gilead said openly at the time that the generics were “priced to more closely reflect the discounts that health insurers and government payers receive today,” because contracts and government pricing rules made it hard to cut the brand list price directly. The authorized generic is the same molecule from the same company in different packaging.
Course length. Mavyret’s 8-week standard course for most treatment-naive patients means two cartons instead of three. That is worth about $12,800 at acquisition cost against its own 12-week price.
Cirrhosis and prior treatment. Patients with compensated cirrhosis or a prior failed regimen may need a longer course or a different drug, which moves the total up. That is a clinical decision, not a shopping decision.
Which pharmacy dispenses it. These are specialty products, and the spread is real: SingleCare’s card price for the authorized generic ranged from $7,826.00 to $8,839.00 per bottle on the same day, a difference of more than $3,000 across a full course.
Whether the prescriber is a specialist. Some state Medicaid programs historically required a specialist to prescribe. The 2026 State of Medicaid Access report cards track prescriber restrictions as one of three key barriers alongside liver damage and sobriety requirements, and several jurisdictions have removed them.
Cash Price vs. Insurance
There is almost no scenario in which paying cash for hepatitis C treatment is the right answer, and that is unusual for this site.
If you have commercial insurance, the manufacturer co-pay programs are aggressive. Gilead states that eligible hepatitis C patients could pay as little as $5 per month through Support Path, and AbbVie states the same $5 figure for Mavyret with a $12,000 lifetime maximum benefit. Neither program is available to anyone on Medicare, Medicaid, TRICARE or VA coverage.
If you are on Medicaid, the picture has improved sharply. As of the start of 2026, 34 states and jurisdictions had removed prior authorization for most patients, according to the Center for Health Law and Policy Innovation and the National Viral Hepatitis Roundtable, and no jurisdiction still requires documented sobriety as a precondition for treatment (Arkansas was the last to drop it). AbbVie’s cost page puts a Medicaid patient’s Mavyret cost at $10.40 or less per month for the 8-week course.
If you have Medicare Part D, the $2,000 annual out-of-pocket cap that took effect January 1, 2025 changed this category more than almost any other, since a single course used to blow through every coverage phase at once. The Medicare Prescription Payment Plan also lets you spread that $2,000 across the calendar year with no fees or interest.
If you are uninsured, the cash price in the table is your worst case, not your expected case. Both manufacturers run patient assistance programs that provide the medicine at no cost to qualifying patients: Gilead’s Support Path covers Epclusa, Harvoni, Vosevi and the Asegua authorized generics, and AbbVie’s myAbbVie Assist covers Mavyret. Apply before you shop.
How to Pay Less
-
Apply to the manufacturer’s patient assistance program before anything else. Support Path is reachable at 1-855-769-7284 and covers both Gilead and Asegua hepatitis C products. myAbbVie Assist covers Mavyret for U.S. residents with limited or no coverage and demonstrated financial need. A qualifying uninsured patient pays $0, which beats every discount card by more than $23,000.
-
Ask specifically for the authorized generic, by name. “Sofosbuvir/velpatasvir by Asegua” is a different NDC from Epclusa and prices roughly one third of it. A pharmacy that stocks one may not stock the other.
-
Check your state Medicaid rules before assuming you are ineligible or will be denied. The State of Medicaid Access project publishes a report card for every state and territory. If you live in one of the 34 jurisdictions that dropped prior authorization for most patients, the paperwork barrier that stopped people in 2018 is simply gone.
-
Get treated at a federally qualified health center or a Ryan White clinic. These are 340B covered entities, meaning manufacturers participating in Medicaid must sell them outpatient drugs at significantly reduced prices. HRSA’s list of covered entities includes health centers, Ryan White clinics, state AIDS Drug Assistance Programs and other safety-net providers, and health centers must give a full sliding-fee discount to patients at or below 100% of the federal poverty guidelines. Our guide to free and sliding-scale clinics explains how to find one.
-
Buy the workup labs at consumer cash prices rather than through a hospital outpatient lab. $545 of consumer-priced blood work can easily be several times that on a hospital chargemaster. Our guides to blood work costs without insurance and hospital price transparency cover how to compare before you sit down for the draw.
-
Do not accept a genotype test without asking whether it will change the plan. With two pangenotypic regimens covering genotypes 1 through 6, it often will not.
-
If a bill has already arrived, treat it as negotiable. Specialty pharmacy and hospital bills in this range are routinely reduced. Our guides to negotiating medical bills and hospital charity care cover the scripts and the application process.
Bottom Line
The list prices on hepatitis C drugs are theater. The three numbers worth remembering are $23,356, which is what a full cure costs in cash at the authorized generic’s acquisition price; roughly $545 plus a $232 to $299 scan, which is what the workup costs before anyone writes the prescription; and $0, which is what a qualifying uninsured patient pays through Support Path or myAbbVie Assist.
The one genuine financial trap left in this category is the gap between diagnosis and treatment, where the antibody test, the viral load, the hepatitis B screen and the fibrosis assessment all get billed before any assistance program is even in play. Price that stretch deliberately.
For the drug-specific numbers on the most commonly prescribed regimen, see our Epclusa cost guide. If you are pricing HIV medication rather than hepatitis C, see our Biktarvy cost guide and our PrEP cost guide. If injection drug use is part of the picture, our Narcan cost guide and Suboxone cost guide price the harm-reduction side. And to sanity-check any quote you have already been handed, use our fair price checker.