EPCLUSA is a prescription medicine used to
treat adults with chronic hepatitis C (Hep C)
genotype 1-6 infection with or without cirrhosis
(compensated).

Important Safety Information

What is the most important information I
should know about EPCLUSA?

What is the most important
information I should know about
EPCLUSA?

EPCLUSA can cause serious side effects, including:

EPCLUSA can cause serious side effects, including:

  • Hepatitis B virus reactivation: Before starting
    EPCLUSA treatment, your healthcare provider will
    do blood tests to check for hepatitis B infection. If
    you have ever had hepatitis B, the hepatitis B virus
    could become active again during and after
    treatment with EPCLUSA. This may cause serious
    liver problems including liver failure and death. If
    you are at risk, your healthcare provider will monitor
    you during and after taking EPCLUSA.

    Hepatitis B virus reactivation:
    Before starting EPCLUSA treatment,
    your healthcare provider will do blood
    tests to check for hepatitis B infection.
    If you have ever had hepatitis B, the
    hepatitis B virus could become active
    again during and after treatment with
    EPCLUSA. This may cause serious liver
    problems including liver failure and
    death. If you are at risk, your
    healthcare provider will monitor you
    during and after taking EPCLUSA.

See complete Important Safety
Information below

CONGRATULATIONS

You have successfully enrolled for an EPCLUSA Co-pay Coupon. A copy of your Co-pay Coupon will be sent to the email or mailing address you provided. You may also print a copy of your Co-pay Coupon. Simply click on "Download Co-pay Coupon" below to print your copy. Your unique Co-pay Coupon information is:

RxBIN: 610020               
RxPCN: EPCLUSA               
RxGRP: 99994027               
ISSUER: 80840
ID#: #couponid#

Download Co-pay Coupon

If you already have a prescription for EPCLUSA, the next step is contacting your pharmacy to obtain your medicine. When filling your prescription, be sure to have your Co-pay Coupon and prescription available, as the pharmacist will need this information to complete your request. Your prescription may need to be filled at a specialty pharmacy.

If you do not have a prescription, be sure to speak to your healthcare provider about your treatment options before attempting to redeem your Co-pay Coupon.

We look forward to assisting you.

Questions?
We're here to help. Call 1-855-7-MYPATH (1-855-769-7284) to speak with an EPCLUSA Support Path® program specialist.



Gilead Logo Support Path Logo
Gilead Logo Support Path Logo

COUPON VALID FOR 6 MONTHS AFTER FIRST REDEMPTION

RxBIN: 610020

RxPCN: EPCLUSA

RxGRP: 99994027

ISSUER: 80840

ID#: #couponid#

EPCLUSA®

(sofosbuvir 400 mg/velpatasvir 100 mg)

Not valid for patients enrolled in government healthcare prescription drug programs. See Terms and Conditions.

Coupon Benefits

  • • Subject to the Gilead Support Path® Co-pay Coupon (“Coupon”) Terms and Conditions, this program provides the following financial assistance for the out-of-pocket costs for eligible commercially insured patients with a valid prescription:
    • ■ Up to a maximum of 25% of the catalog price for three bottles in cost-sharing assistance, valid for 6 months from the time of first redemption with no monthly limit for the following product:
      • ⚬ EPCLUSA® (sofosbuvir 400 mg/velpatasvir 100 mg)
  • • As described in the Coupon Terms and Conditions, Gilead may reduce or discontinue the financial assistance available under the Coupon if it determines the patient is subject to an “accumulator adjustment” or “co-pay maximizer” program.
      • ⚬ If Gilead determines that a patient’s insurer (or its agent) has implemented a program that adjusts patient cost-sharing obligations based on the availability of support under the Coupon program (sometimes called a “co-pay maximizer program”), unless prohibited by law, Gilead may reduce or discontinue the cost-sharing assistance available under the Coupon after providing assistance in an amount not to exceed $9,500.
      • ⚬ If Gilead determines that a patient’s insurer (or its agent) has implemented a program that excludes the financial assistance provided under the Coupon program from counting towards the patient’s deductible or out-of-pocket cost limitations (sometimes called an “accumulator adjustment program”), unless prohibited by law, Gilead may reduce the cost-sharing assistance available under the Coupon to a per claim maximum of $25. Please contact Support Path® at 1‑855‑769‑7284 to determine if additional cost-sharing assistance is available.
  • • These Coupon benefits are subject to change for any reason at any time without notice.

Gilead Support Path® Co-pay Coupon Terms and Conditions:

  • • The Gilead Support Path® Co-pay Coupon (“Coupon”) provides financial assistance for the out-of-pocket costs for eligible commercially insured patients as described in the Coupon Benefits above. Coupon benefits are limited to financial assistance for patient cost-sharing for the applicable Gilead product only.
  • • The Coupon can be used only by eligible residents of the US, Puerto Rico, or US territories at participating eligible pharmacies in the US, Puerto Rico, or US territories. Product must be dispensed in the US, Puerto Rico, or US territories. Individuals must be at least 18 years old to use the Coupon themselves or to enroll in the Coupon on behalf of a minor.
  • • To use the Coupon, the patient (or the patient’s legal representative on behalf of the patient, as applicable) must personally complete the enrollment process for the Coupon. Third-party payers, pharmacy benefit managers, or the agents of either, are prohibited from assisting patients with enrolling in the Coupon. Any decision to enroll in the Coupon must be made voluntarily by the patient.
  • • The Coupon is not insurance and is not intended to substitute for insurance. Uninsured and cash-paying patients are not eligible to use the Coupon. The Coupon is valid only for prescriptions that are reimbursed by commercial insurance and is not valid for prescriptions that are eligible to be reimbursed:
      • – in whole or in part by Medicare or a Medicare Part D plan, Medicaid, TRICARE, VA, DOD, Puerto Rico Government Health Insurance Plan, or any other state or federally funded healthcare benefit program (collectively, “Government Programs”); or
      • – by commercial plans or other health or pharmacy benefit programs that reimburse for the entire cost of prescription drugs or prohibit the Coupon’s use.
  • • Patients who begin receiving prescription benefits from Government Programs at any time must notify Gilead of this fact by contacting Support Path at 1‑855‑769‑7284 and will no longer be eligible to use the Coupon.
  • • The Coupon is limited to one per person and is not transferable. No substitutions are permitted. This Coupon is offered to, and intended for the sole benefit of, eligible patients and may not be utilized for the benefit of third parties, including, without limitation, third-party payers, pharmacy benefit managers, or the agents of either. If Gilead determines that a patient’s insurer has implemented a program that adjusts patient cost-sharing obligations based on the availability of support under the Coupon program (sometimes called a “co-pay maximizer program”), unless prohibited by law, Gilead may reduce or discontinue the cost-sharing assistance available under the Coupon after providing assistance in an amount not to exceed $9,500. If Gilead determines that a patient’s insurer has implemented a program that excludes the financial assistance provided under the Coupon program from counting towards the patient’s deductible or out-of-pocket cost limitations (sometimes called an “accumulator adjustment program”), unless prohibited by law, Gilead may reduce the cost-sharing assistance available under the Coupon to a per claim maximum of $25. Patients may contact Support Path® at 1‑855‑769‑7284 to determine if additional cost-sharing assistance is available.
  • • The Coupon is only available with a valid prescription. No other purchase is necessary to redeem this offer.
  • • The Coupon cannot be combined with any other coupon, free trial, discount, prescription savings card, or other offer (including, without limitation, any program offered by a third-party payer or pharmacy benefit manager, or an agent of either, that adjusts patient cost-sharing obligations). Patients are not eligible to use the Coupon for a product if they are currently receiving free drug assistance through Gilead Sciences, Inc. (“Gilead”)’s patient assistance program for that product.
  • • The Coupon will not reimburse any payments made by Flexible Spending Account (FSA), Health Savings Account (HSA), Health Reimbursement Account (HRA), or any other payor, discount/co-pay program, or other offer.
  • • Void where prohibited by law, taxed, or restricted.
  • • Patient, pharmacist, and prescriber agree not to seek reimbursement for all, or any part of the benefit received by the patient through the Coupon. Both patient and pharmacist are each individually responsible for reporting receipt of the Coupon benefit to any insurer, health plan, or other third party who pays for or reimburses any part of the prescription filled using the Coupon, as may be required.
  • • It is illegal to sell, purchase, trade, or counterfeit, or offer to sell, purchase, trade, or counterfeit the Coupon.
  • • Certain information pertaining to your use of the Coupon will be shared with Gilead, the sponsor of the Coupon, and its affiliates. The information disclosed will include the patient co-pay ID, pharmacy demographics, prescriber information, and details relating to the coupon claim, such as co-pay amount, insurance details, and the therapy received. For more information, please see the Gilead Privacy Policy at www.gilead.com/privacy.
  • • Gilead Sciences reserves the right to terminate, rescind, revoke, or modify the Coupon for any reason at any time without notice.

If you have any questions regarding your co-pay coupon, please call Support Path® at 1-855-769-7284, Monday through Friday, from 9 am to 8 pm Eastern Time.

Gilead Logo

EPCLUSA, SUPPORT PATH, the SUPPORT PATH Logo, GILEAD, and the GILEAD Logo are trademarks of Gilead Sciences, Inc., or its related companies.

©2023 Gilead Sciences, Inc. All rights reserved. US-ADMC-0180 06/23

IMPORTANT SAFETY INFORMATION

What is the most important information I should know about EPCLUSA?

EPCLUSA can cause serious side effects, including:

  • •

    Hepatitis B virus reactivation: Before starting EPCLUSA treatment, your healthcare provider will do blood tests to check for hepatitis B infection. If you have ever had hepatitis B, the hepatitis B virus could become active again during and after treatment with EPCLUSA. This may cause serious liver problems including liver failure and death. If you are at risk, your healthcare provider will monitor you during and after taking EPCLUSA.

    • What should I tell my healthcare provider before taking EPCLUSA?

  • •

    Tell your healthcare provider about all of your medical conditions, including if you have ever had hepatitis B infection, liver problems other than hepatitis C infection, or a liver transplant; if you have kidney problems or are on dialysis; if you have HIV; or if you are pregnant or breastfeeding, or plan to become pregnant or breastfeed. It is not known if EPCLUSA will harm your unborn baby or pass into your breast milk.

    Tell your healthcare provider about all of your medical conditions, including if you have ever had hepatitis B infection, liver problems other than hepatitis C infection, or a liver transplant; if you have kidney problems or are on dialysis; if you have HIV; or if you are pregnant or breastfeeding, or plan to become pregnant or breastfeed. It is not known if EPCLUSA will harm your unborn baby or pass into your breast milk. If you take EPCLUSA with ribavirin, you should also read the ribavirin Medication Guide for important pregnancy-related information.

  • •

    Tell your healthcare provider and pharmacist about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. EPCLUSA and certain other medicines may affect each other, or may cause side effects.

    • What are the possible side effects of EPCLUSA?

    Serious side effects may also include:

  • •

    Slow heart rate (bradycardia): EPCLUSA, when taken with amiodarone (Cordarone®, Nexterone®, Pacerone®), a medicine used to treat certain heart problems, may cause slow heart rate. In some cases slow heart rate has led to death or the need for a pacemaker when amiodarone is taken with medicines containing sofosbuvir. Get medical help right away if you take amiodarone with EPCLUSA and get any of the following symptoms: fainting or near-fainting, dizziness or lightheadedness, not feeling well, weakness, extreme tiredness, shortness of breath, chest pains, confusion, or memory problems.

  • •

    The most common side effects of EPCLUSA in adults include headache and tiredness.

    • These are not all the possible side effects of EPCLUSA. Call your doctor for medical advice about side effects.

    You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.

    What is EPCLUSA?

    EPCLUSA is a prescription medicine used to treat adults with chronic (lasting a long time) hepatitis C (Hep C) genotype 1-6 infection with or without cirrhosis (compensated).

    EPCLUSA is a prescription medicine used to treat adults with chronic (lasting a long time) hepatitis C (Hep C) genotype 1-6 infection with or without cirrhosis (compensated). In those with advanced cirrhosis (decompensated), EPCLUSA is used with ribavirin.

    Please see Important Facts about EPCLUSA including Important Warning.

    Tap for Important Safety Information about EPCLUSA including Important Warning on hepatitis B reactivation.