Why is sofosbuvir and velpatasvir (Epclusa) expensive in China? What is the domestic price?

Sofosbuvir (Epclusa) combination with velpatasvir is indicated for the treatment of adult patients with chronic hepatitis C virus (HCV) genotype 1, 2, 3, 4, 5 or 6 infection without cirrhosis or compensated cirrhosis, or in combination with ribavirin if concomitant with decompensated cirrhosis. The combination of sofosbuvir and velpatasvir is prohibited with strong inducers of liver enzymes CYP2B6, CYP2C8 or CYP3A4, or P-glycoprotein, which may reduce the effectiveness of the drug.

Sofosbuvir is a nucleotide analog inhibitor that prevents HCV viral replication by binding to the two Mg2+ ions present in the GDD active site motif ofHCV NS5B polymerase and preventing further replication of HCV genetic material. Velpatasvir may be similar to other selective NS5A inhibitors that bind to NS5A domain I consisting of amino acids 33-202. NS5A inhibitors compete with RNA for binding to this site. Common side effects(more than 10% of people) are headache, fatigue and nausea. Serious side effects occurred in 3% of patients in the study, and 0.2% discontinued treatment due to adverse events.

The original drug of sofosbuvir and velpatasvir is an imported drug. It has entered the scope of Class B medical insurance after being launched in China. The domestic trade name is Bintongsa, and the specification is (400mg+100mg) * 28 tablets. The price per box is about 4,000 yuan. The original drug of sofosbuvir and velpatasvir has also been launched overseas. There are also generic drugs of sofosbuvir and velpatasvir produced in other countries. The specifications of the Bangladesh Everest Pharmaceutical Factory are (400mg + 100mg) * 28 tablets per box, and the price is around RMB 850 (the price may fluctuate due to the exchange rate). The generic drugs produced abroad are basically the same as the original drugs at home and abroad.