OBJECTIVES: This study reports the long-term cost per sustained virologic response (SVR) with Viekira Pak (ombitasvir, paritaprevir and ritonavir, dasabuvir) with and without ribavirin and standard of care in the US, including sofosbuvir plus simeprevir (SOF+SMV) and sofosbuvir plus peg-interferon and ribavirin (SOF+PR), among patients with genotype 1 (GT1) chronic hepatitis C virus (HCV) infection. METHODS: A Markov cost-effectiveness model was used to estimate the long-term cost of HCV. The analysis modeled independent cohorts of GT1 HCV patients over a lifetime horizon with annual cycles from a US payer perspective. Liver disease progression was assessed based on previous natural history model. Direct medical costs (in 2014 prices and discounted at 3% per year) were obtained from the published literature. Efficacy and safety data were obtained from published clinical trials. SVR rates were stratified by patient treatment history, cirrhosis status, and sub-genotype, where available. Long-term cost per SVR for a patient segment was calculated by dividing total cost of HCV over patient’s lifetime by the mean SVR rate in that patient segment. RESULTS: The long-term cost per SVR with Viekira Pak ranged from $88,305 to $94,433 in GT1 non-cirrhotic patients (12-week regimen), $125,748 (12-week) to $216,520 (24-week) in GT1 cirrhotic patients, $94,433 to $141,413 in GT1a and $88,332 to $125,748 in GT1b treatment-naïve patients (12-week). Long-term cost per SVR with SOF+SMV was $164,725 (12-week) in GT1 non-cirrhotic patients, and $341,569 (24-week) in GT1 cirrhotic patients, all treatment histories combined. Long-term cost per SVR with SOF+PR was $116,713 in GT1a and $134,561 in GT1b naïve patients (12-week). CONCLUSIONS: The long-term cost per SVR was lower in non-cirrhotic than in cirrhotic patients across all regimens.  The results of this study suggest that the use of Viekira Pak is a clinically and economically viable strategy for GT1 HCV treatment.