Epclusa Versus Mavyret

The Short Story
In the past 12 months there has been a fundamental game shift in the treatment of Hepatitis C with the arrival of AbbVie’s new pan-genotype drug Mavyret. (Pan-genotype means that the drug treats all genotypes of Hepatitis C.)Mavyret is set up in direct completion with Gilead’s pan-genotype Hep C drug Epclusa.

Whilst Mavyret and Epclusa are quite similar in their effectiveness for treating Hepatitis C AbbVie decided to launch Mavyret at the significantly lower price of around US$20,000 for a treatment. Much, much less than the US$84,000 price tag that Gilead had on Epclusa and Harvoni.

This lower price and huge savings immediately meant that USA based health insurance companies, and national health services around the world, had their doctors prescribing Mavyret for treating all genotypes of Hep C where they had previously prescribed Epclusa or Harvoni.

Aside from the issue of price, controversy has revolved around the question of which drug is actually better for treating Hepatitis C, Mavyret or Epclusa? And where do Harvoni and Sofosbuvir + Daclatasvir fit into the equation of treatment options?

Well the answer is actually very simple, both Epclusa and Mavyret are about the same if the person who is being treated has not failed a previous treatment and does not have a high liver fibrosis level.

However if a person has high liver fibrosis or cirrhosis or has failed a previous Hep C treatment then Epclusa is marginally a better treatment than Mavyret.

And it just might be that the drug combination of Sofosbuvir + Daclatasvir is better than both.

So if you have health insurance and the doctor prescribes either Epclusa or Mavyret, or you are getting the medication supplied by your national health service, there is no significant difference in treatment outcomes between Mavyret and Epclusa.

However, if you must purchase your Hepatitis C treatment with your own money the fact is that there is no generic version of Mavyret but there is a licensed generic Epclusa, generic Harvoni and the very cheap option of Sofosbuvir + Daclatasvir.

So, whilst the cost difference between brand Mavyret and brand Epclusa favours Mavyret if you decide to buy generic Epclusa you are looking at a price of US$1,000 per treatment against a price of US$20,000 per treatment for Mavyret. Given that there is no significant advantage in Mavyret over Epclusa then generic Epclusa is obviously the best treatment choice. As you will see below, if you have genotype 1 generic Harvoni and Sofosbuvir + Daclatasvir are both excellent and low priced treatment options.

Both Mavyret and Epclusa give cure rates above 97% for all genotypes of Hepatitis C except for G3 where both give a cure rate of around 95%. It appears that people with cirrhosis or who have failed previous treatments would get greater benefit from Epclusa than fro Mavyret. Sofosbuvir + Daclatasvir appears to be as effective as either Mavyret or Epclusa.

Click here to read “the long story” and the rest of Greg’s blog. This blog originally appeared on Greg Jefferys’ Hep C Treatment Home Page, and is republished with permission.