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How does Epclusa work in the body?

Medically reviewed by Carmen Fookes, BPharm Last updated on May 10, 2020.

Official Answer

by Drugs.com
  • Epclusa contains two antiviral ingredients, sofosbuvir and velpatasvir, and may be used to treat hepatitis C.
  • Sofosbuvir interferes with the reproduction of genetic material of the hepatitis C virus, by inhibiting an RNA-dependent polymerase called HCV NS5B, which is also needed by the virus to replicate itself.
  • Velpatasvir works by interfering with a protein, called HCV NS5A that is needed by the virus to replicate itself.

Epclusa contains two antiviral ingredients, sofosbuvir and velpatasvir, and may be used to treat chronic hepatitis C in adults and children over the age of six.

Sofosbuvir interferes with the reproduction of genetic material of the hepatitis C virus, by inhibiting an RNA-dependent polymerase called HCV NS5B, which is also needed by the virus to replicate itself. Sofosbuvir is a prodrug, which means it is metabolized in the body to its active component and incorporated into the DNA of the HCV virus. Sofosbuvir also works directly on viral RNA and does not inhibit human DNA or RNA.

Velpatasvir is an NS5A (hepatitis C virus nonstructural protein 5A) inhibitor. Velpatasvir works by interfering with a protein, called HCV NS5A that is needed by the virus to replicate itself. This protein is the main target for velpatasvir, meaning velpatasvir works directly on the virus, not on human cells.

How is Epclusa given?

Epclusa is usually given as a single dose once daily with food. Cure rates range from 89% to 100% depending on the HCV genotype and other factors (such as prior treatment).

Epclusa is manufactured by Gilead Sciences Ltd and there a generic version of Epclusa called Velpatasvir and sofosbuvir oral tablets (manufactured by Asegua Therapeutics LLC).

What is the cost of Epclusa?

Epclusa is expensive. It costs $930 for each tablet (400mg/100mg) depending on the pharmacy you visit. Prices are for cash paying customers only and are not valid with insurance plans. This corresponds to an average cost of $26,026 for a 4-week treatment course, $52,052 for an 8-week treatment course, and $78,078 for a 12-week treatment course.

Most insurance companies and Medicare cover the cost of Epclusa; however, you may have to meet certain criteria and you should always check with your insurance company first before you and your doctor make it your preferred treatment. There may also be a co-pay.

Gilead, the manufacturer of Epclusa has a special patient assistance program called Support Path™ that may assist with co-pay insurance coupons or make Epclusa available at no charge for eligible and qualified uninsured patients insurance who need assistance paying for their out-of-pocket medication costs. To learn more about Support Path, call +1 855 769 72846, Monday through Friday between 9:00 a.m. and 8:00 p.m. (Eastern Time).

If you have no success getting Epclusa at a reduced cost through Gilead’s Support Path, you could try organizations that offer help to people with hepatitis C, such as the American Liver Foundation, Hepatitis Foundation International, or Needy Meds.

What is Epclusa used for?

Epclusa may be used to treat chronic hepatitis C in adults with genotypes 1 to 6, with or without cirrhosis. In those with decompensated cirrhosis, it should be given in conjunction with ribavirin.

Epclusa may also be used to treat chronic hepatitis C in children aged 6 years and older or weighing at least 37 lbs (17kg). 

References
  • Epclusa (velpatasvir and sofosbuvir) Gilead Sciences, Inc. https://www.drugs.com/pro/epclusa.html

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