Comparison of Recommended First-Line Direct-Acting Antiviral Regimens Used for Treatment of Treatment-Naïve Hepatitis C Patients, as of 1/1/2018
| Name of Direct-Acting Antiviral Combination Product | Ledipasvir/Sofosbuvir (Harvoni), 90 to 400 mg | Velpatasvir/Sofosbuvir (Epclusa), 100 to 400 mg | Grazoprevir/Elbasvir (Zepatier), 50 to 100 mg | Glecaprevir/Pibrentasvir (Mavyret), 100 to 40 mg |
|---|---|---|---|---|
| Drug classes | NS5a-NS5b | NS5a-NS5b | NS3/4-NS5a | NS3/4-NS5a |
| Genotypes | 1, 4, 5, 6 | 1, 2, 3, 4, 5, 6 | 1 and 4 | 1, 2, 3, 4, 5, 6 |
| Dosage for noncirrhotic patients | 1 tablet daily for 12 weeks* | 1 tablet daily for 12 weeks | 1 tablet daily for 12 weeks† | 3 tablets daily for 8 weeks |
| Can be used in patients with severe CKD (CrCl <30 mL/min) | No | No | Yes | Yes |
| Cost estimate‡ | $96,000 | $75,000 | $55,500 | $27,000 |
↵* Genotype 1 patients who are non-black, HIV-uninfected, and whose HIV RNA level is <6 million IU/mL may be treated with 8 weeks of Ledipasvir/Sofosbuvir
↵† For Genotype 1a patients without baseline NS5a resistance associated substitutions for elbasvir (positions 28, 30, 31, or 93), all Genotype 1b patients, and all Genotype 4 patients.
↵‡ Estimated retail price of treatment based on information obtained at http://www.goodrx.com (accessed January 4, 2018).