How to Help Your Patients Save Money on Epclusa: A Provider's Guide to Savings Programs

With a list price of approximately $24,350 for a 28-day supply, Epclusa's cost can be an immediate barrier when patients see the price tag on their prescription. But the reality is that most patients — with the right guidance — can access Epclusa at a dramatically reduced cost or no cost at all. As a provider, knowing the available savings pathways is critical for ensuring that your patients actually start and complete treatment.

This guide organizes the key savings programs by patient insurance status, so you can quickly direct each patient to the right resource.

For Commercially Insured Patients: Gilead Support Path Co-Pay Card

The most widely applicable savings tool for commercially insured patients is the Gilead Support Path Co-Pay Savings Card. Here are the key clinical and administrative details:

• Patient cost: As low as $5/month
• Benefit structure: Covers up to 25% of the catalog price for 3 bottles over 6 months (no monthly limit within that cap)
• Eligibility: Must have commercial (employer or marketplace) insurance; US citizen 18+ or eligible minor; valid Epclusa prescription; NOT on government insurance (Medicare/Medicaid)
• Enrollment: MySupportPath.com or 1-855-769-7284 (Mon–Fri, 9 AM–8 PM ET)

Important note for providers: If your patient's insurer uses a co-pay accumulator or co-pay maximizer program, the co-pay card funds may not count toward their deductible. In these cases, Gilead may reduce the assistance available. Advise patients to call Support Path to clarify how their specific plan interacts with the program.

For Uninsured Patients: Gilead Support Path Patient Assistance Program

Uninsured patients who meet income criteria may qualify to receive Epclusa at no charge through the Patient Assistance Program (PAP). The program handles sourcing directly from Gilead and requires:

• Completion of an enrollment application (available at MySupportPath.com)
• Income documentation (income thresholds are verified by program specialists)
• A valid prescription from a licensed provider in the US

Your office can initiate the enrollment by contacting Support Path on behalf of the patient. This is particularly valuable for patients in the uninsured gap or those in states without Medicaid expansion.

For Medicaid Patients: Prior Authorization and State-Specific Coverage

All 50 state Medicaid programs cover Epclusa, typically at copays of $0–$5. However, Medicaid PA criteria vary significantly by state. Common Medicaid PA requirements for Epclusa include:

• Confirmed HCV RNA and genotype
• Fibrosis stage documentation — some states previously required advanced fibrosis (F2+), though many have expanded access to all fibrosis stages
• Sobriety requirements — some states require 30–90 days of documented sobriety from alcohol or illicit substances (though these requirements have been challenged and many states have relaxed them)
• Prescriber requirements — some states require a hepatologist, gastroenterologist, or infectious disease specialist to prescribe (not a PCP)

Check your state's Medicaid clinical PA criteria through your state's pharmacy bulletin or contact Gilead's Support Path for state-specific Medicaid guidance.

For Medicare Patients: Part D Coverage and the 2026 OOP Cap

Epclusa is covered by Medicare Part D plans. In 2026, the annual out-of-pocket cap for Part D is $2,100. Once a patient reaches this cap, their plan covers 100% of the cost. For a drug like Epclusa, this cap is significant — it means that even without additional assistance, Medicare patients have a defined maximum exposure.

For Medicare patients with limited income, Medicare Extra Help (Low Income Subsidy, LIS) can further reduce Part D costs. Advise eligible patients to apply through Social Security Administration. Gilead's co-pay card is NOT available for Medicare patients, so Extra Help or patient assistance may be needed for those with cost concerns.

The Authorized Generic: A Lower-Cost Option for Cash-Paying Patients

Asegua Therapeutics (a Gilead affiliate) produces an authorized generic of sofosbuvir/velpatasvir 400 mg/100 mg with a list price of approximately $6,728 for 28 tablets — about $17,600 less per month than brand-name Epclusa. The active ingredients, manufacturing quality, safety, and efficacy are identical.

When prescribing for cash-paying patients, write "Dispense as Written" or explicitly request the authorized generic to ensure the pharmacy knows which version to dispense. Discount cards (GoodRx, SingleCare) may provide additional savings on the authorized generic for cash-paying patients.

For HCV/HIV Coinfected Patients: ADAP

Epclusa is included in the AIDS Drug Assistance Program (ADAP) formulary in most states. ADAP provides prescription coverage for HIV/AIDS-related medications for uninsured and underinsured patients. Contact your state's ADAP program directly to confirm Epclusa is covered and guide patients through enrollment.

Streamlining the Process: A Practice Workflow Recommendation

Consider building the following into your standard HCV treatment initiation workflow:

1. At the decision visit: Ask the patient about insurance status and identify the appropriate savings pathway (co-pay card, PAP, Medicaid, Medicare Extra Help)
2. Submit PA with complete documentation — including HCV RNA, genotype, FIB-4/FibroScan, HBsAg/anti-HBc — at the same time as prescribing
3. Connect patient with Gilead Support Path (1-855-769-7284) on the same day
4. Confirm specialty pharmacy and send prescription to the correct location

Direct patients who are struggling to locate their prescription to medfinder for Providers. For clinical and access details, see our provider's guide on Epclusa access barriers.