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A new pill could end COVID deaths, but too pricy?

Molnupiravir

This new pill has seen great success in reducing the contraction of the Coronavirus, according to a recent press release from the pharmaceutical company Merck & Co

The pill interferes with a specific enzyme that the COVID-19 virus uses to copy its genetic code Scientists gave either Molnupiravir or a placebo to 775 people The US government is paying about $700 per course of the drug

Although other countries are in hot pursuit of this magic COVID-19 pill, with Singapore’s health ministry signing a purchase agreement for it, and the European Medicines Agency considering a rolling review of the drug, regulatory approval is required before the US releases the treatment, aka Molnupiravir.

This new pill has seen great success in reducing the contraction of the Coronavirus, according to a recent press release from the pharmaceutical company Merck & Co.

The company, along with and Ridgeback Therapeutics, claims a five-day course of the drug successfully reduced coronavirus hospitalizations, along with deaths linked to subsequent illness, by 50%.

If the new pill is cleared for emergency use, it would become the first orally ingested means of treating the COVID-19 illness.  

“A safe, affordable, and effective oral antiviral would be a huge advance in the fight against COVID,” said Professor Peter Horby of emerging infectious diseases at the University of Oxford, in the U.K., according to a Reuters report.

While these results are extremely promising, they have yet to undergo peer review. The firm’s executives claim they’re already in discussions with the Food and Drug Administration, and will submit an application for the drug to receive emergency use authorization immediately.

Molnupiravir
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Merck’s new pill operates by interfering with a specific enzyme that the COVID-19 virus uses to copy its genetic code and consequently reproduces it in the human body.

Molnupiravir belongs to a class of antivirals called mutagenic ribonucleosides. These change the viral genetic material and introduce errors to prevent replication and transcription of the viral genome.

Notably, this pill has also seen similar results against other viruses, which means it could have wider applications than helping to curb a global pandemic.

Drug trials and results

Medical News Today explored the evidence to see whether this optimism is justified.

Scientists gave either Molnupiravir or a placebo to 775 people. All the participants had tested positive for SARS-CoV-2 infections and experienced mild to moderate COVID-19 symptoms that had begun no more than 5 days earlier.

Every participant had at least one risk factor for severe COVID-19 but had not been admitted to a hospital. Risk factors included obesity, an age of over 60 years, diabetes, and heart disease.

The scientists allocated each of the 775 participants randomly to one of two groups. One group received Molnupiravir and the other a placebo.

Of the 385 patients taking Molnupiravir, 28 were admitted to a hospital, compared with 53 of those in the placebo group. Eight of the placebo group participants died, while all those receiving the antiviral were alive at the end of the 29-day study period.

The treatment involves four 200-milligram capsules, twice a day, for five days or a total of 40 pills.

Molnupiravir was also effective against all variants, including the Delta variant, which was shown in a recent study to have a 235% increased risk of intensive care unit admission, compared with the original variant.

Merck plans to produce 10 million courses of the treatment in 2021 and more in 2022.

The projected cost of around $700 per person for a 5-day course.

Do the bills fit the pill?

Already, at least eight countries or territories in the Asia-Pacific region have signed deals or are in talks to procure the drug, according to analytics company Airfinity, including New ZealandAustralia, and South Korea, all of which were relatively slow to start their vaccine programs.

In Asia-Pacific, where vaccine rates in many countries have improved after a slow start, millions of people are still not inoculated either because they don’t qualify, or they can’t access shots.

Some of those countries may be trying to avoid mistakes of the past when slow orders led to delayed vaccine rollouts.

The United States agreed to pay $1.2 billion for 1.7 million courses if the pill is approved, meaning the government is paying about $700 per course. An analysis by researchers Melissa Barber and Dzintars Gotham found that it costs about $18 to produce a course of Molnupiravir based on a calculation of the cost of raw materials.

Merck did not confirm whether those estimates were accurate, although in a statement to CNN, the company said the calculations don’t take into account research and development.

“We have not yet established a price for Molnupiravir because it has not been approved for use,” the company said.  

In a statement in June, Merck said it planned to use a tiered pricing approach for different countries, and had also entered into licensing agreements with generic manufacturers to accelerate the availability of the pill in 104 low- and middle-income countries.