How Much Does Harvoni Cost With Medicare?
Harvoni (Ledipasvir/Sofosbuvir) costs an average of $24,958 per Medicare Part D claim, with total Medicare spending of $1198.0M in the latest year. No generic alternative is currently available.
Key Facts: Harvoni Cost
- Medicare Part D avg
- $24,958/claim
- Likely Part D tier
- Tier 4-5 (specialty)
- Annual cost/patient
- $99,833
- Generic available
- No
- Manufacturer
- Gilead
- Treats
- Hepatitis C
- Patent expires
- 2030-10-10
- YoY price change
- -38.2%
Source: CMS Medicare Part D Spending Dashboard. Tier placement inferred from typical formulary norms — confirm with your specific Part D plan.
Harvoni Medicare Coverage & Out-of-Pocket Cost
Harvoni is covered under Medicare Part D, with the program paying an average of $24,958 per prescription fill. Harvoni typically falls on Tier 4-5 (specialty) of standard Part D formularies. Specialty drugs use coinsurance (25-33% of plan-negotiated price), not flat copays. The 2025 Part D annual out-of-pocket cap is $2,000.
Your actual out-of-pocket cost depends on three factors: (1) formulary tier — your plan's specific placement; (2) deductible status — most plans require you to meet up to a $590 deductible (2025) before copays kick in; (3) coverage phase — initial coverage, then the donut hole was eliminated in 2025, replaced by a hard $2,000 annual out-of-pocket cap under the Inflation Reduction Act. Once you hit $2,000 in true out-of-pocket spending, the rest of your Part D drugs are free for the year.
No generic is currently available for Harvoni. Medicare beneficiaries cannot use manufacturer copay cards (anti-kickback statute prohibits them for federal program enrollees), but charity foundations such as the PAN Foundation, NeedyMeds, and the HealthWell Foundation offer copay grants for many hepatitis c drugs. The Medicare Extra Help (LIS) program also reduces Part D costs to near-zero for income-qualified beneficiaries (under 150% of the federal poverty level).
For cash-pay or commercial insurance scenarios, compare prices using GoodRx, SingleCare, or Cost Plus Drugs before filling — discount-program prices sometimes beat Part D copays for lower-cost generics.
Harvoni is manufactured by Gilead and prescribed primarily for Hepatitis C. In the most recent Medicare Part D data, 48,000 claims were filed for 12,000 unique beneficiaries, at an average cost of $24,958 per claim. Average annual cost per beneficiary is $99,833.
Year over year, Medicare spending on Harvoni has decreased by -38.2%. No generic substitute is available, so the brand-name price reflects the full market cost. Its patent expires 2030-10-10.
Key Data
| Metric | Value |
|---|---|
| Avg Cost Per Claim | $24,958 |
| Total Medicare Spending | $1198.0M |
| Total Claims | 48,000 |
| Beneficiaries | 12,000 |
| Generic Available | No |
| Year-Over-Year Change | -38.2% |
Other Drugs for Hepatitis C
Frequently Asked Questions
Medicare Part D pays an average of $24,958 per claim for Harvoni. Harvoni is typically placed on Tier 4-5 (specialty) of standard Part D formularies. Specialty drugs use coinsurance (25-33% of plan-negotiated price), not flat copays. The 2025 Part D annual out-of-pocket cap is $2,000. As of 2025, total annual out-of-pocket on Part D is capped at $2,000 under the Inflation Reduction Act.
Yes. Harvoni appears in Medicare Part D claims data, with 12,000 beneficiaries filling 48,000 prescriptions in the latest year. Specific coverage depends on your plan's formulary — call the number on your insurance card or check the plan's Summary of Benefits to confirm prior authorization, step therapy, or quantity limit requirements.
Harvoni (Ledipasvir/Sofosbuvir) costs an average of $24,958 per Medicare Part D claim, with total Medicare spending of $1198.0M in the latest year. No generic alternative is currently available.
No. As of the latest FDA Orange Book data, there is no generic version of Harvoni (Ledipasvir/Sofosbuvir). Patent protection extends until 2030-10-10, after which generics may enter the market.
Medicare beneficiaries cannot use manufacturer copay cards (anti-kickback statute), but several options exist: (1) Apply to charity copay foundations like the PAN Foundation, NeedyMeds, HealthWell Foundation, or Patient Advocate Foundation — many cover hepatitis c drugs; (2) Ask your prescriber about therapeutic alternatives in the same drug class that may be on a lower tier; (3) For some drugs, paying cash via GoodRx or Cost Plus Drugs can beat your Medicare copay — always compare before filling; (4) If your income is below 150% of the federal poverty level, you may qualify for the Medicare Extra Help (Low-Income Subsidy) program, which reduces Part D costs to near-zero.
Harvoni is manufactured by Gilead. The FDA application number is NDA205834.
Harvoni (Ledipasvir/Sofosbuvir) is primarily prescribed for Hepatitis C.
Medicare Part D spending on Harvoni has decreased -38.2% year over year. Total program spending reached $1198.0M in the latest reporting year.
Harvoni (Ledipasvir/Sofosbuvir) costs an average of $24,958 per Medicare Part D claim, with total Medicare spending of $1198.0M in the latest year. No generic alternative is currently available.
This answer pulls from CMS Medicare Part D Drug Spending data, the authoritative federal source for U.S. Medicare prescription-drug pricing. The headline number above is the direct answer; what follows is the additional context most readers need to use the answer for a real decision rather than just a fact lookup.
For readers turning this answer into action: cross-reference against the underlying CMS Medicare Part D Drug Spending data record before acting on time-sensitive decisions. The site renders the data as it was published; subsequent revisions can shift the picture, and the live federal data is always the authoritative current reference.
Source: CMS Medicare Part D Spending, 2026.