OBJECTIVES: New Hepatitis C (HCV) therapies are more effective at treating HCV, but come at higher financial costs. Boceprevir has been used with peginterferon and ribavirin antivirals for treatment of HCV, achieving sustained virologic response (SVR) rates of 65% in clinical trials. Simeprevir, sofosbuvir and combination ledipasvir and sofosbuvir are new therapies that have achieved SVR of over 90% in phase III clinical trials. Estimating the cost effectiveness of these new therapies is important for providers to determine which treatments to adopt in the context of growing cost concerns. METHODS: We used Markov simulation to evaluate the cost effectiveness of simeprevir, sofosbuvir and combination therapy ledipasvir and sofosbuvir vs. the assumed standard of care, boceprevir, among HCV genotype 1 patients over a 30-year time horizon. Patients progress through stages of the natural history of HCV-liver fibrosis/cirrhosis, liver transplant and death. Costs, QALYs and outcomes were estimated from clinical trials and previously published literature. We calculated the incremental net monetary benefit (INMB) between each therapy and standard of care. We ran multivariate probabilistic sensitivity analyses (PSA) to quantify the uncertainty of the results.  RESULTS: New therapies have higher costs and yield higher QALYs than boceprevir. Simeprevir at 12 and 24 weeks have the highest INMB ($85,335.02 and $19,069.64, respectively). Sofosbuvir/ribavirin has a net monetary loss compared to the standard of care. The results identify the simeprevir therapy to be the most cost effective. PSA reveals simeprevir has the highest likelihood of being cost-effective as compared to boceprevir when all inputs are varied simultaneously. CONCLUSIONS: Of the new HCV therapies, simeprevir therapy is the best value for money when compared to boceprevir.  Simeprevir yields the highest QALYs of the newer therapy regimens.  Further research should focus on patient adherence to therapy and associative costs of adverse events to better elucidate value.