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Merck Molnupiravir Anti-COVID Drug – An Additional String to the Bow?


Merck has developed a specific antiviral drug that prevents the replication of SARS-CoV-2 when administered early in the course of COVID infection.  The company announced the results of a clinical trial involving 175 participants in a double-blind study.  Recipients of the drug that is administered orally required only half the rate of hospitalization and prevented mortality compared to controls receiving a placebo.  In contrast there were eight deaths in the placebo cohort.


Dr. Robert Davis, president and CEO of Merck stated, “With these compelling results, we are optimistic that molnupiravir can become an important medicine as part of the global effort to fight the pandemic.”  He added that Merck will expand all possible efforts to increase production” Merck anticipates releasing 10 million courses each of 10 capsules by the end of 2021.  With an incidence rate of 125,000 cases per day, the U.S. would theoretically require approximately 12 million courses during the fourth quarter if the drug is widely prescribed. 


Wendy Holman, CEO of Ridgeback Biotherapeutics, co-developer of the drug noted, “With the virus continuing to circulate widely, and because therapeutic options currently available require infusion and access to a healthcare facility, antiviral treatments that can be taken at home and that will keep people with COVID-19 out of the hospital are critically needed.”


Subject to FDA emergency use approval, the U.S. Government will purchase 1.7 million courses of molnupiravir for $1.2 billion.  This computes to $706 per treatment less expensive than monoclonal antibody infusions at about $1,250. Both treatments are still far more expensive than vaccination at approximately $25 per dose.  Administration of molnupiravir will require testing that will add to the expense. 


Molnupiravir as an antiviral drug is no panacea for COVID but has a definite application for non-vaccinated individuals, especially in high-risk groups who become infected.  In considering both the economic and societal implications of a therapeutic drug, should the U.S. Government pay $750 to protect an individual who declined a $25 vaccination that would have kept them out of a hospital? Other questions relating to an oral virucidal drug include the inevitability of inappropriate or repeated use by the non-vaccinated, the emergence of resistance by strains of influenza virus as occurred with oseltamivir at $100 per course at out-of-pocket cost and strengthening of anti-vaccine sentiment.


Speculators who sold Pfizer (PFE) and Moderna (MRNA) on Friday October 1st driving down  share prices by 13.6 and 14.2 percent respectively and boosting Merck (MRK) by 9.6 percent reacted to gut feel and sentiment without thinking through the issue.