| Hepatitis C, Chronic
Vosevi vs Epclusa
Side-by-side clinical, coverage, and cost comparison for hepatitis c, chronic.Deep comparison between: Vosevi vs Epclusa with Prescriber.AI
AI compares prescribing info and payer-specific access barriers across 1,200+ formularies. Here's a preview of what prescribers are already asking.Safety signalsEpclusa has a higher rate of injection site reactions vs Vosevi based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Epclusa but not Vosevi, including UnitedHealthcare
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Category
Vosevi
Epclusa
At A Glance
Oral
Once daily
NS5B polymerase + NS5A + NS3/4A protease inhibitor combination
Oral
Once daily
NS5B polymerase and NS5A inhibitor
Indications
- Hepatitis C, Chronic
- Hepatitis C, Chronic
Dosing
Chronic Hepatitis C (genotype 1-6, NS5A inhibitor-experienced) One tablet (400 mg sofosbuvir, 100 mg velpatasvir, 100 mg voxilaprevir) orally once daily with food for 12 weeks
Chronic Hepatitis C (genotype 1a or 3, sofosbuvir without NS5A inhibitor) One tablet (400 mg sofosbuvir, 100 mg velpatasvir, 100 mg voxilaprevir) orally once daily with food for 12 weeks
Chronic Hepatitis C (genotypes 1-6, without cirrhosis or compensated cirrhosis) One 400 mg/100 mg tablet orally once daily for 12 weeks (adults); weight-based dosing for pediatric patients 3 years and older (150 mg/37.5 mg for <17 kg, 200 mg/50 mg for 17-<30 kg, 400 mg/100 mg for >=30 kg) once daily for 12 weeks.
Chronic Hepatitis C (genotypes 1-6, with decompensated cirrhosis Child-Pugh B or C) One 400 mg/100 mg tablet orally once daily plus weight-based ribavirin (1,000 mg/day if <75 kg, 1,200 mg/day if >=75 kg, divided twice daily) for 12 weeks.
HCV/HIV-1 coinfection Follow dosing recommendations as above based on cirrhosis status.
Liver transplant recipients (without cirrhosis or compensated cirrhosis) One 400 mg/100 mg tablet orally once daily for 12 weeks.
Contraindications
- Coadministration with rifampin
- Contraindications applicable to ribavirin when used in combination with EPCLUSA (refer to ribavirin prescribing information)
Adverse Reactions
Most common (>=10%) Headache, fatigue, diarrhea, nausea
Serious Symptomatic bradycardia when coadministered with amiodarone, hepatic decompensation, hepatic failure
Postmarketing Skin rashes with blisters or angioedema-like swelling, angioedema
Most common (>=10%) in subjects without cirrhosis or compensated cirrhosis Headache, fatigue
Most common (>=10%) in subjects with decompensated cirrhosis (with ribavirin) Fatigue, anemia, nausea, headache, insomnia, diarrhea
Most common (>=10%) in HCV/HIV-1 coinfected subjects Fatigue, headache
Additional reactions (5-<10%) in subjects without cirrhosis or compensated cirrhosis Nausea, asthenia, insomnia, irritability
Less common (<5%) in subjects without cirrhosis or compensated cirrhosis Rash, depressed mood
Less common (<10%) in subjects with decompensated cirrhosis Rash
Serious Serious symptomatic bradycardia when coadministered with amiodarone
Postmarketing Serious symptomatic bradycardia with sofosbuvir-containing regimens and amiodarone, skin rashes with blisters or angioedema-like swelling, angioedema
Pharmacology
VOSEVI is a fixed-dose combination of three direct-acting antivirals: sofosbuvir (NS5B polymerase inhibitor), velpatasvir (NS5A inhibitor), and voxilaprevir (NS3/4A protease inhibitor) that target distinct steps in the HCV replication cycle.
Sofosbuvir is a nucleotide prodrug that inhibits HCV NS5B RNA-dependent RNA polymerase by incorporating into viral RNA and acting as a chain terminator. Velpatasvir inhibits the HCV NS5A protein required for viral replication.
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Most Common Insurance
Anthem BCBS
Vosevi
- Covered on 5 commercial plans
- PA (11/12) · Step Therapy (10/12) · Qty limit (11/12)
Epclusa
- Covered on 5 commercial plans
- PA (12/12) · Step Therapy (1/12) · Qty limit (11/12)
UnitedHealthcare
Vosevi
- Covered on 4 commercial plans
- PA (7/8) · Step Therapy (4/8) · Qty limit (7/8)
Epclusa
- Covered on 4 commercial plans
- PA (4/8) · Step Therapy (0/8) · Qty limit (4/8)
Humana
Vosevi
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (3/3) · Qty limit (3/3)
Epclusa
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (1/3) · Qty limit (3/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
$5/fillfill
Gilead Support Path Co-pay Coupon: VoseviCommercial or private insurance
Medicare, Medicaid, VA, TRICARE
No savings programs available for Epclusa.
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.