Hey there! If you’ve landed on this page, chances are you (or someone you love) is facing the tough decision of which hepatitis C medication to choose. It can feel a bit like being stuck at a crossroads with two shiny signs pointing in different directions: Mavyret and Epclusa. The good news? Both drugs are power‑houses that cure the virus in the overwhelming majority of cases. The real question is which one lines up best with your health situation, budget, and lifestyle.
In the next few minutes we’ll walk through the most important factors side by side—efficacy, who can safely take each drug, dosing schedules, side‑effects, cost, and even a couple of real‑world stories. Think of it as a friendly coffee chat where I’m laying out everything on the table so you can make an informed choice without the jargon overload.
Quick Comparison Table
| Feature | Mavyret (glecaprevir/pibrentasvir) | Epclusa (sofosbuvir/velpatasvir) |
|---|---|---|
| FDA‑approved genotypes | All 1‑6 (pan‑genotype) | All 1‑6 (pan‑genotype) |
| Typical treatment length | 8 weeks (12 weeks if compensated cirrhosis) | 12 weeks (8 weeks for select patients) |
| Cirrhosis eligibility | Compensated (Child‑Pugh A) only | Compensated & decompensated (Child‑Pugh B/C) |
| Pill burden | 3 tablets / day (or pellets) | 1 tablet / day |
| SVR12 (cure) rate* | 97‑99 % | 95‑99 % |
| Brand price (U.S.)** | ≈ $20 K for 8 weeks | ≈ $84 K for 12 weeks |
| Generic available? | No (yet) | Yes – licensed generic around $1 K |
Cure rates come from phase‑III trials (e.g., EXPEDITION‑8 for Mavyret, ASTRAL‑4 for Epclusa).
*Prices are list‑price, before insurance or manufacturer coupons.
For a deeper dive into the numbers, see our Mavyret cost and Mavyret dosing pages.
Efficacy Overview Summary
Both Mavyret and Epclusa belong to the newer generation of direct‑acting antivirals (DAAs). They work by shutting down the virus’s ability to replicate, but they target different viral proteins. Mavyret blocks the NS3/4A protease, while Epclusa inhibits both NS5A and the RNA‑dependent RNA polymerase (NS5B). The result? Viral loads plummet to undetectable levels, and most patients stay virus‑free after treatment.
According to the FDA’s prescribing information, Mavyret achieved a 98 % sustained virologic response at 12 weeks (SVR12) in treatment‑naïve patients without cirrhosis (FDA label). Epclusa posted a comparable 96‑98 % SVR12 across the same groups (FDA label).
So, if you’re asking, “Are they equally effective?” the short answer is yes—both cure rates sit comfortably above 95 %. The nuances appear when you look at special populations (high fibrosis, decompensated cirrhosis, or previous DAA failure). A 2018 HepMag article noted that Epclusa “can also be used to treat people with decompensated cirrhosis, while Mavyret cannot” (Greg Jefferys, Mavyret versus Epclusa).
Who Should Use
Here’s where the rubber meets the road. Your liver condition, prior treatment history, and even your age can tip the scales.
- Compensated cirrhosis (Child‑Pugh A): Both drugs are safe and effective. If an 8‑week course sounds appealing, Mavyret may be the easier option.
- Decompensated cirrhosis (Child‑Pugh B/C): Epclusa is the only FDA‑approved choice. Mavyret is not recommended for this level of liver dysfunction.
- Prior DAA failure or genotype 3 with high fibrosis: Some clinicians lean toward Epclusa because the data suggest a slight edge in these tougher scenarios.
- Age considerations: Epclusa can be prescribed to children as young as three, while Mavyret’s approval starts at age 12.
In short, if you have a healthy liver or only compensated cirrhosis, you can comfortably choose either. If you’re navigating decompensated disease, Epclusa is the clear frontrunner.
Dosing Details Guide
Both regimens are taken orally, but the day‑to‑day routine is different enough to matter for busy lives.
Mavyret Dosing (glecaprevir/pibrentasvir)
- Take three tablets (or three pellets) once daily with food. Food increases absorption and reduces the chance of stomach upset.
- Standard course: 8 weeks for patients without cirrhosis; 12 weeks** for those with compensated cirrhosis.
Need the nitty‑gritty? Check our Mavyret dosing guide for a printable schedule.
Epclusa Dosing (sofosbuvir/velpatasvir)
- Take one tablet daily, with or without food—super convenient.
- Standard course: 12 weeks for most patients. An 8‑week regimen is allowed for certain genotype 3 patients without cirrhosis.
Both drugs are taken at the same time each day, so set a reminder on your phone or pair it with a daily habit like brushing your teeth.
Side Effects Summary
When you’re on a life‑changing medication, you want to know what to expect. The good news: both Mavyret and Epclusa are generally well‑tolerated, and most side‑effects are mild and short‑lived.
Most Common Adverse Events
- Headache – reported by ~27 % (Mavyret) and ~30 % (Epclusa) of users (Drugs.com).
- Fatigue – appears in around 21 % of both cohorts.
- Nausea – 14‑19 % depending on the drug.
- Diarrhea – roughly 6‑7 %.
Most people report these symptoms as “nothing that stops me from my daily routine.” They usually fade within the first week or two.
Rare but Important Concerns
- Reactivation of hepatitis B – Both drugs can trigger hepatitis B flare‑ups in patients who have a dormant infection. Your doctor should test for hepatitis B before starting either medication.
- Transient liver decompensation – More reports have surfaced for Mavyret in patients with existing cirrhosis. This is why it isn’t approved for decompensated disease.
- Drug‑drug interactions – Strong CYP3A inducers (e.g., rifampin, St. John’s wort) and grapefruit can raise drug levels. Always give your pharmacist a full medication list.
After You Stop – Long‑Term Outlook
Both medications have been studied for years, and no persistent toxicity has been identified after successful treatment. In other words, once the virus is cleared, the drugs essentially disappear from your system, leaving you with a clean bill of health—provided you didn’t develop a chronic hepatitis B infection.
Cost & Insurance
Money matters, especially when a cure costs tens of thousands of dollars on paper. Let’s break down the economics.
List Prices (Before Insurance)
- Mavyret – roughly $20,000 for an eight‑week course.
- Epclusa – roughly $84,000 for a twelve‑week course.
These figures come from the 2018 HepMag analysis and the Drugs.com pricing tables.
Discount Programs & Patient Assistance
Both AbbVie (Mavyret) and Gilead (Epclusa) run patient‑assistance foundations that can shave hundreds or even thousands off the out‑of‑pocket cost. If you have private insurance, the drug‑specific formulary will dictate which one is preferred. Many plans favor the lower‑priced option—Mavyret—unless you have decompensated cirrhosis, in which case they may require Epclusa.
Generic Landscape
- Epclusa – A licensed generic is on the market, often priced around $1,000 per treatment course, making it dramatically cheaper for uninsured patients.
- Mavyret – No lower‑cost generic exists yet. The “Mavyret generic” search still points to ongoing research but no approved product (Mavyret generic discussion).
If price is the primary driver, the Epclusa generic can be a game‑changer, but you’ll need to confirm it’s appropriate for your genotype and liver status.
Real‑World Patient Stories
Data is great, but stories stick. Here are two snapshots that illustrate how the same virus can meet different lives.
Story 1 – “Eight Weeks and I’m Back”
Mark, a 42‑year‑old accountant with genotype 1, no cirrhosis, and a modest insurance plan, asked his hepatologist which drug would be easiest to fit into his busy schedule. The doctor recommended Mavyret because the eight‑week course meant fewer pills and a lower copay. Mark took three tablets with breakfast, set a daily alarm, and after two weeks reported only a mild headache. By week eight, his labs showed “undetectable HCV RNA.” He celebrated by finally taking that long‑overdue vacation.
Story 2 – “When the Liver Needs Extra Help”
Lena, a 58‑year‑old with decompensated cirrhosis (Child‑Pugh B), had tried several regimens in the past with mixed success. Her specialist explained that Mavyret isn’t approved for her liver stage, but Epclusa is. Lena started the 12‑week Epclusa course, took the single tablet with dinner, and monitored her liver enzymes closely. Although she experienced some mild fatigue, by week twelve her viral load was undetectable and her bilirubin began to trend downwards. “I felt seen,” Lena wrote in a support forum, “because my doctor matched the drug to my exact liver condition.”
These stories show that while both drugs are powerful, the right fit depends on the individual’s health landscape.
Putting It All Together
Let’s recap the big picture in a friendly “cheat‑sheet” style so you can walk away with clarity:
- Effectiveness: Both have > 95 % cure rates; choose based on special circumstances.
- Who can use it: If you have decompensated cirrhosis, Epclusa wins. For compensated disease or no cirrhosis, both are options.
- Duration: Mavyret often finishes in 8 weeks, Epclusa typically 12 weeks.
- Convenience: Epclusa’s single‑tablet regimen is ultra‑simple; Mavyret requires three tablets (or pellets) daily with food.
- Side‑effects: Similar mild profiles; watch for hepatitis B reactivation.
- Cost: Mavyret’s list price is lower, but Epclusa’s generic can be dramatically cheaper if you qualify.
- Patient assistance: Both manufacturers have programs; check your insurance formulary first.
Now, imagine you’re sitting across from your doctor with this cheat‑sheet. You can ask clear, focused questions:
- “Given my liver status, which drug is medically safer for me?”
- “Do I qualify for a patient‑assistance program or a generic version?”
- “What should I avoid while taking the medication?” (what is Mavyret used for includes guidance on food and interaction warnings.)
Ending on a hopeful note: whether you choose Mavyret or Epclusa, you’re stepping onto a path that has turned hepatitis C from a chronic, life‑threatening disease into a curable condition for the overwhelming majority of patients. That’s something worth celebrating.
Take the Next Step
If you’re ready to discuss options with your healthcare provider, bring this article (or a printed copy) with you. It can serve as a conversation starter and help ensure you get the most personalized, evidence‑based recommendation.
Got questions, personal experiences, or tips you think could help others? Feel free to reach out to a trusted medical professional or a reputable patient‑support community. Remember, you’re not alone on this journey—there’s a whole network of clinicians, pharmacists, and fellow patients cheering you on.
Wishing you health, clarity, and a swift cure!
Leave a Reply
You must be logged in to post a comment.