Zepatier vs Harvoni vs Epclusa – Which One Is The Best For You?

We get a lot of questions about which one Hepatitis C medicines is the best. Is Harvoni better than Sovaldi? How about Harvoni vs Zepatier? Is Viekira Pak comparable to Sovaldi? Does Olysio even work? Daklinza, is this some kind of Harvoni?… And so on.

Check out our brand new Hepatitis C forum and start a discussion.

It depends on the patient – Primarily on Genotype, and Sex, Age, State of the Liver

To clear the air, we made a comparison of Harvoni vs Sovaldi vs Viekira Pak vs Olysio vs Zepatier vs Daklinza. The truth is that the most appropriate drug is usually chosen by a doctor to best fit the needs of the patient. However, we strongly believe that patients should know what kind of drugs they are buying and taking and be active in their treatment as well – it is nevertheless the health of oneself that is at stake.

Not all Hepatitis C drugs cure all genotypes

In our comparison, we considered cure rates, side effects and cost of all available Hepatitis C medications that came to the market in last 3 years. In the end, we will extract an overall conclusion of Hepatitis C medications and try to objectively justify which one is the best choice for Hepatitis C patients.

Short Intro of Hepatitis C Drugs (in chronological order)

Prior to December 2013, there was only one cure for Hepatitis C – interferon injections. It was a course of treatment that lasted for 6 months, had severe side effects and only 50% cure rate. Hepatitis C changed when the first of the new line of antivirals came out. They called it Sovaldi. In two years time, many other Hepatitis C drugs joined Sovaldi and today we consider Hepatitis C a curable disease exclusively because of the invention of these drugs.

zepatier vs harvoni vs sovaldi vs viekira pak vs olysio timeline hepatitis c drugs

Update: On 28th June, 2016, Gilead Sciences launched Epclusa, the first Hepatitis C drug for all genotypes.

Sovaldi by Gilead Sciences – FDA approval: December 6, 2013

The approval of Sovaldi for chronic Hepatitis C in December 2013 was truly historic event in the history of medicine. Literally overnight, more than 100 million of people with fatal Hepatitis C, thinking there are little options and no clear solution, just got a clear option and a clear solution in Sovaldi.

Hepatitis C patients were used to treated with interferon injections and ribavirin which was only 50% successful, included stabbing patients with needles and it usually took 6 months. Headaches were frequent and bad.

Sovaldi changed all that. 400 mg sofosbuvir pills were just that – pills.

A pill per day for 12 weeks with light headaches and you have about 95% chance of getting cured of Hep C. That is Sovaldi in a nutshell. (Richard Brenson, MD)

Harvoni by Gilead Sciences – FDA approval: October 10, 2014

Less than a year before the revolutionary 400 mg sofosbuvir pills (Sovaldi) were introduced, Gilead took a step forward and launched Harvoni in October 2014. Harvoni pills consist of 400 mg of sofosbuvir like Sovaldi, with an addition of 90 mg of ledipasvir (antiviral drug molecule).

Harvoni beat the sales records with easy and Gilead currently sells around $10 billion of Hepatitis C treatment per year. Why? It's price tag is $94,500 per standard treatment. The generic Harvoni such as Hepcinat LP is much cheaper.

 

Viekira Pak by AbbVie – FDA approval: December 19, 2014

viekira pak abbvie hepatitis c ombitasvir ritonavir dasabuvir

AbbVie was the first to challenge Gilead's domination in treating Hepatitis C by introducing Viekira Pak in December 2014 (1 year after the launch of Sovaldi). Viekira Pak consists of two-pill regimen – here is how you take it:

  • 1 pill of dasabuvir (250 mg) two times per day (morning and evening)
  • 2 pills of ombitasvir/paritaprevir/ritonavir once a day (morning)

It may be an unusual regimen but Viekira Pak cure rate is above 90% and has light side effects.

Daklinza by Bristol-Myers Squibb – FDA approval: July 24, 2015

daklinza daclatasvir with sofosbuvir for genotype 3 hepatitis c

BMS joined the Hepatitis C market in summer of 2015 with Daklinza. Daklinza (daclatasvir) is used with the newly developed sofosbuvir molecule (Sovaldi) to treat especially problematic genotype 3. In the past, even with Sovaldi, genotype 3 was treated with Sovaldi and interferon; and everyone hates using injectable interferon if there is a pill solution. And Daklinza was just the pill solution that was needed to genotype 3 patients.

Zepatier by Merck – January 28, 2016

zepatier elbasvir and grazoprevir tablets merck hepatitis c

Zepatier is the latest in the line of new-age Hepatitis C treatments. Developed by Merck, Zepatier has joined Gilead's Harvoni and AbbVie's Viekira Pak to offer a formidable variety of choice for every Hepatitis C patients.

A very important difference of Zepatier (elbasvir and grazoprevir pill) is it's price tag – only $54,600 per standard treatment. This is still widely considered an extremely high cost but Harvoni and Viekira Pak are even costlier.

Olysio by Janssen – FDA approval: November 22, 2013

olysio simeprevir genotype 1 hepatitis c

Olysio is somewhat an exception in modern Hepatitis C treatment in that it still includes old interferon and ribavirin in the treatment regimen (this is why we named it last). Despite the burdensome regimen, however, Olysio with its simeprevir drug molecule has an overall 94% cure rate.

The irony of Olysio is that it was a superb innovation in Hepatitis C treatment but it was released merely two weeks before the release of a truly not only superb, but a wonder drug – Sovaldi by Gilead Sciences.

A best Hepatitis C drug for each genotype

One very important thing to bear in mind is that not all drugs cure all Hepatitis C genotypes. This is essential to understand when choosing the right drug for the right patient. Here is the distribution of patients across genotypes in the US.

hepatitis c genotype distribution in the us harvoni sovaldi zepatier viekira pak

As you can see the from pie chart above, the most prevalent form of Hepatitis C virus is genotype 1 (GT1). This is also why all new drugs are trying best to heal especially genotype 1. On the other hand, each of genotype 4, 5 and 6 represents less than 1% of all Hepatitis C patients. Pharmaceutical companies don't actively make drugs for GT 4,5 and 6; what is more, even if they know drug like Viekira Pak might work for genotype 6, it would not be profitable for them to registered it as such because they would have to conduct costly clinical trials specifically on genotype 6 patients.

As of 2016, a new medicine Epclusa was developed that effectively treats all genotypes. Here is generic version of the medicine called Sofosvel.
And what is even more important: While being on Hepatitis C treatment, the body actually needs more healthy food to fight off disease effectively. 

Importance of taking care of your liver

Hepatitis C treatment will only get rid of your Hepatitis C-related problems.

It is important to always take care of your liver, before treatment, during treatment as well as after treatment. The best way to keep the lift and keep the healthy liver functions is by eating a healthy and balanced diet as well as exercising. In modern stressful times, however, this is in many cases not enough.

liver support detox for hepatitis c patients

There are some very good liver detoxification natural supplements such as Liver Cleanse Detox Supplements containing milk thistle and uva-ursi extract to name just a few. Liver Cleanse Detox does not only help upkeep normal liver functions, but also boosts energy and promotes weight loss.

Other natural supplements for liver detoxification and healthy liver functions include:

Keep in mind that using natural supplements can slow down the process of liver cirrhosis in Hepatitis C patients, according to several key studies.

 

 

Comparison of Hepatitis C drugs – Harvoni vs Sovaldi vs Viekira Pak vs Olysio vs Zepatier vs Daklinza

Comparison of Hepatitis C medications

Comparing the cure rate, treatment options, regimen, side effects and costs of modern Hepatitis C drugs. The values are average numbers for each medicine.
Hepatitis C DrugsSovaldiHarvoniViekira PakDaklinzaZepatierOlysio
Companygilead sciences logogilead sciences logoabbvie logo viekira pakbristol myers squibb hepatitis c logomerck logo zepatierjanssen logo daklinza
Which Genotype does the drug treat?GT 1, 2, 3 and 4GT 1 and 4
Not approved but helpful with GT 3, 5, 6
GT 1GT 1, 2, 3 and 4
*with sofosbuvir
GT 1 and 4GT 1
*with sofosbuvir
Cure RateGT 1: 90%
GT 2: 96%
GT 3: 93%
GT 4: 84%
*Sovaldi clinical results
96%
*Harvoni clinical results
97%
*Viekira Pak clinical results
GT 1: 100%
GT 2: 96%
GT 3: 89%
GT 4: 80%
*Daklinza clinical results
GT 1: 95%
GT 4: 98%
*Zepatier clinical results
94%
*Olysio clinical results
Treatment regimen- 1 pill of Sovaldi per day (with or without ribavirin, interferon)
- 12 weeks
- 1 pill of Harvoni per day
- 12 weeks
- 1 pill of dasabuvir (250 mg) two times per day (morning and evening)
- 2 pills of ombitasvir/paritaprevir/ritonavir once a day (morning)
- 1 pill of Daklinza daily
- 1 pill of 400mg sofosbuvir daily
- 12 weeks
- 1 pill of Zepatier dailyAs prescribed by doctor (may differ from patient to patient)
Common Side Effects- fatigue
- headache
- nausea
-insomnia
- fatigue
- headache
- nausea
-insomnia
- fatigue
- headaches
- nausea
- itching
- skin rash
- insomnia
- tiredness
- headache
- pyrexia
- influenza-like illness
- asthenia
- fatigue
- nausea
- headache
- anemia (decrease in number of red blood cells)
- stomach pain
- allergic reactions (rashes, irritation)
- nausea
- muscle pain
- mild itching or rashes
Cost per treatment (in the US)$80,000$94,500$83,319$63,000$54,600$66,360
To rememberFirst all-oral Hep C treatmentTop-Notch Hep C Drug (also 'The expensive one')Genotype 1b DrugSovaldi + something Hep C DrugThe low-price oneOk, but not the best

Sovaldi vs Harvoni vs Viekira Pak vs Zepatier vs Daklinza vs Olysio for Genotype 1

Majority of Hepatitis C patients have genotype 1 (73%). A great news is that all modern Hepatitis C drugs have been designed to cure genotype 1. Looking at the cure rate, all of them are 90% successful.

Daklinza and Olysio are very successful not because of itself but because of the inclusion of sofosbuvir (Sovaldi) in the treatment. This is why they are less recommended.

Up till now, it was between Harvoni vs Viekira Pak in genotype 1. They have comparable common side effects and cure rates. However, what is comes down to is the cost and the regimen. Viekira Pak in comparison with Harvoni has a very complex regiment taking multiple pills per day while Harvoni is a simple 1-pill per day regimen. On the other hand, Harvoni is also the most expensive Hepatitis C drugs and arguably the most successful drug on the market.

Harvoni's price may be an issue but patients can always follow our instruction for getting generic Harvoni from India for about $1000 per treatment. Being a single most successful Hepatitis C drug, it is a recommended course of treatment especially for genotype 1a. Viekira Pak is generally recommended for genotype 1b.

However, in January 2016, Zepatier entered the game – it offers similar cure rate and simple regimen as Harvoni but at a considerably lower cost (Zepatier costs $54,600 and Harvoni costs $94,500). This is why Zepatier can be referred to as a game changer in Hepatitis C market.
A generic version of Harvoni – Hepcinat LP by Natco Pharma – is finally available online. A UK company DharmaGroup Ltd. has managed to secure the distribution of generic Harvoni more than a year after it was first introduced. More and more patients prefer to buy Hepcinat LP online instead of traveling to India and buying it there (so called ‘medical tourism‘). Finally every Hepatitis C patient can get generic Harvoni shipped to his or home address by ordering it online – you can order your generic Harvoni for less than $3,000 here from UK. *The original Harvoni in the US costs $94,500.

Sovaldi vs Daklinza for Genotype 2

13% of all Hepatitis C patients suffer from genotype 2. However, only two medications are registered to be used as a treatment: Sovaldi and Daklinza.

Daklinza consists of daclatasvir and sofosbuvir (which is basically Sovaldi) and has the same cure rate and similar side effects as Sovaldi. However, it's price is also much lower than Sovaldi, and given that the medications are very comparable, one is recommended to opt for the low-cost version of Daklinza.

Sovaldi vs Daklinza for Genotype 3

For genotype 3 the situation is pretty much similar to genotype 2. 12% of people that have genotype 2 can be treated with Sovaldi or Daklinza. However, in this case, Sovaldi had 93% cure rate while Daklinza had 89%, a notable difference. With everything else except the price being the same, the recommendation for treating genotype 3 goes to Sovaldi. If you can get the generic Sovaldi from India, you actually eliminate the price factor as well.

Sovaldi vs Harvoni vs Daklinza vs Zepatier for Genotype 4

As you can see from the table above, Sovaldi and Daklinza cure rate results for genotype 4 were not as strong as those of Harvoni and Zepatier. This is why Sovaldi and Daklinza za very rarely recommended for genotype 4 therapy.

Harvoni was an undisputed champion for genotype 4 Hepatitis C patients. This high cure rate, mild side effects and simple regimen, the only thing that patients find problematic is it's extreme price tag. No one, however, questions how miraculous the drug actually is at curing Hepatitis C.

However, in January 2016, Zepatier was introduced and designed specifically for chronic Hepatitis C genotype 4. If you look at Zepatier vs Harvoni, you'll see they are very comparable in almost everything – the main difference is the price. Harvoni has been enjoying a monopol but now Zepatier is the one who will most likely challenge it with it's considerably lower price tag.

Harvoni is still the recommended course of treatment but considering the price of Harvoni and Zepatier, it is possible that Zepatier will become the most recommended treatment for genotype 4.

Would you like to ask us something?

We hope that we had shed a bit of much-needed light on the matter of what to consider when choosing Hepatitis C treatment and encouraged patients to be more independent.

If you have any questions relating to Hepatitis C treatments or Hepatitis C in general, feel free to state them in the comments and we'll be happy to answer them.

8 thoughts on “Zepatier vs Harvoni vs Epclusa – Which One Is The Best For You?

  • October 11, 2016 at 4:13 am
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    My request to obtain Epclusa Tablet was rejected. I am required to try Daklinza, Harvoni, Vieira Pak or Zepatier before coverage is authorized. I have hepC genotype 1. Do you have any data on Epclusa which was approved by the FDA for treatment of chronic hepatitis C virus infection?

  • October 8, 2016 at 5:11 pm
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    You’ve got geno 3 wrong, best combo is sofosbuvir plus daclastivir! For 12 or 24 weeks with or without ribavirin depending on cirrhosis!

  • August 29, 2016 at 2:42 pm
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    im newly dianosed with hcv. how can i access medication in kenya. i dont know the genotype of virus i have. though i have insurance cover still im stuck. pls may u direct me so i get early treament coz now im not having any single sign. thanks. yu can even call me directly since i need immediate help through 0728154360

  • July 26, 2016 at 5:50 pm
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    Anemia is only caused with Zepatier if you take ribavirin, any of the hep c combos taken with ribavirin cause anemia even harvoni. This article is not accurate with side effects of Zepatier it should be headache and fatigue as shown in the Zepatier PI , providing partial facts for these drugs is exactly why you should be discussing with your provider not reading what people inccrrectly wrote on the Internet.

    • May 18, 2016 at 1:48 am
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      I have heart disease, a five artery bypass in 2009 and a very low ejection fraction of 20. I’m very concerned about side effects. I have type 1a Hep-C and my doctor wanted Harvoni for me but my insurer wants to use Zepatier because of the cost. One of the side effects of zepatier is anemia and this could be very serious for me. How can I get my insurance to allow Harvoni for me. What is the process to fight them. Thanks Jim

      • May 22, 2016 at 9:40 pm
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        take it from egypt . harvoni cost 5500 for all course 3 months. in dollar 500 dollar

    • July 25, 2016 at 1:46 pm
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      My Insurens will only pay for Zepatier and I am worried about the side affects I have a stress that is PD SD and iam sick to my stomic thinking about it , , I would like to take Vickira is there any way that I can get my insures to pay for the one that dusent give the bad side effects I have high blood pursuer as well please can you help me

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