How much does Harvoni cost and does health insurance cover it?
- Harvoni is expensive. Twenty-eight Harvoni 45mg/200mg oral tablets cost around $32,896
- An eight-week treatment course is approximately $65,000, a 12-week course is $98,500, and a 24-week course around $197,000 without insurance or funding
- Most insurance companies and Medicare cover Harvoni; 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 or Harvoni has a special patient assistance program called Support Path™ that may assist with co-pay insurance coupons or make Harvoni available at no charge for eligible and qualified uninsured patients
- Harvoni is also available as a generic called ledipasvir/sofosbuvir. Twenty-eight ledipasvir/sofosbuvir 90mg/400mg oral tablets cost $10, 090.
How expensive is Harvoni?
According to the Drugs.com price guide which bases its price on the Drugs.com discount card which is accepted at most U.S. pharmacies the cost for Harvoni oral tablets (45 mg/200 mg) is around $32,896 for a supply of 28, 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 $1,175 per pill, $65,000 for an 8-week treatment course, $98,500 for a 12-week treatment course, and $197,000 for a 24-week course.
Harvoni is available as a generic, under the name ledipasvir/sofosbuvir. The cost for oral ledipasvir/sofosbuvir tablets (90 mg/400 mg) is around $10,090 for a supply of 28, depending on the pharmacy you visit. Prices are for cash paying customers only and are not valid with insurance plans.
All of the new HCV (hepatitis C) oral agents are very expensive, and usually out of reach for patients without adequate insurance unless other funding options can be organized.
Although most insurance plans and Medicare include oral direct-acting HCV agents in their formulary, it is recommended you check with your insurance company before you and your doctor decide upon Harvoni as your treatment of choice to be sure it is a preferred regimen.
The level of insurance cover for hepatitis C treatments can vary, depending on a person’s insurance policy and overall health. Some insurance companies will pay for people whose hepatitis C has not responded to less-expensive treatments or for those who are already showing signs of liver damage. And some may require a person to prove they have been drug- and alcohol-free before authorizing treatment.
If your insurance company will not pay for Harvoni, they require a copay, or you have no insurance, Gilead, the manufacturer of Harvoni, has a special Patient Assistance Program called Support Path™ that covers Harvoni for certain people.
This patient assistance program assists eligible Hepatitis C patients in the United States to access Harvoni (ledipasvir/sofosbuvir) and other Gilead manufactured hepatitis C products and provides the following services:
- Insurance-related information, education and support including a 24/7 nursing support line
- Co-pay coupon programs, which provide co-pay assistance for eligible patients with private insurance who need assistance paying for their out-of-pocket medication costs. Most eligible patients will pay no more than $5 per co-pay (restrictions apply). Not valid for patients enrolled in government health care prescription drug programs, such as Medicare Part D and Medicaid. Patients in the coverage gap known as the "donut hole" also are not eligible
- Harvoni at no charge for eligible and qualified uninsured patients.
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 Harvoni 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 NeedyMeds.
Blog sites also report the following:
- "My total cost for 12 weeks of Harvoni was $15.00. When you order your Harvoni, ask about the assistance program to help you with the cost. I didn't think that I will qualify because of my insurance and income, but I was surprised that I did. You must talk to your health insurance company to find out how much they will pay. You can also contact Gilead's patient services. Talk to your Doctor as well. Some hospitals have Foundations that can support you too. It will take some doing but it's worth the effort. The state helps people as well but ... there is always a but... you have to fit into certain criteria, like the amount of money you make and how much money you put out of pocket for all medical needs, etc Good Luck!"
- "First I would talk to your GI doctor and tell him/her your situation. There are foundations out there that the doctor or his reps should know about that can help you. If he doesn't know, try calling the hospital he is affiliated with and ask them. Some of these foundations work through the Hospital, For instance, HUP, (Univ of Penna) helped me."
- "Contact Gilead. My insurance turned me down and they gave the first month free. May not apply but ask anyway. Medicare should pick up some of the cost. Contact your US senator and representatives as well. Hopefully, their staff will assist."
What is Harvoni?
Harvoni is a combination tablet containing ledipasvir and sofosbuvir. It may be used to treat certain genotypes of hepatitis C in adults and children over the age of three.
Ledipasvir is an NS5A inhibitor and sofosbuvir is a nucleotide polymerase (NS5B) inhibitor. Harvoni prevents the hepatitis C virus (HCV) from multiplying in the body. It is a single combination pill that is given by mouth once a day for 8, 12, or 24 weeks, depending upon your HCV status.
- Harvoni [Package Insert] 11/2019 Gilead Sciences, Inc https://www.drugs.com/pro/harvoni.html
- How much does hepatitis C treatment cost? 11/2018 Medical News Today https://www.medicalnewstoday.com/articles/323767#if-you-dont-have-insurance
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