Vaccines remain the best shield against COVID-19, but for those who’ve been infected with the coronavirus, the treatment arsenal continues to expand. This month, the first antiviral pill to treat COVID was submitted to the Food and Drug Administration (FDA) for emergency authorization.
Merck & Co. developed the oral pill in conjunction with Ridgeback Bioetherapeutics, which in January 2020 submitted the drug, whose chemical name is molnupiravir, for treatment of seasonal influenza. When the COVID pandemic struck, the company shifted the drug’s focus on coronavirus.
Vaccination definitely is the umbrella over everything. But if we can treat COVID with these oral medications, I think it changes the efficiency of care altogether. – Peter Anderson, PharmD
Until molnupiravir, which is being distributed to several other countries and possibly in the United States within a few weeks, only the antiviral agent remdesivir, a few monoclonal antibody medicines and a smattering of anti-inflammatories and blood thinners have been available to treat COVID cases. Remdesivir and the anti-SARS-CoV-2 monoclonal antibody treatments are administered via intravenous infusion, requiring a trip to a clinic or hospital.
Peter Anderson, PharmD, a professor in the Department of Pharmaceutical Sciences at the Skaggs School of Pharmacy and Pharmaceutical Sciences and an expert in the prevention and treatment of HIV infection, said molnupiravir’s efficacy is “a very exciting development” and expects that oral pills taken at home, in combination with other medications, are the future of COVID treatments.
“These oral drugs could have much more impact than the infusions,” Anderson said. “They can reach so many more people.”
Besides the unvaccinated, who remain the most susceptible to COVID, there are millions of people in the United States who are immune-suppressed and may not be able to mount a full, protective immune response after vaccination.
Molnupiravir underwent a randomized trial on adults with mild-to-moderate cases of COVID-19. The drug reduced the risk of hospitalization by about 50% in unvaccinated adults who had shown early symptoms and were at high risk for unfavorable outcomes from the virus. Over a span of almost a month, no deaths occurred in the patients who received the drug, but eight died in the placebo group.
While emergency authorization could be several weeks away, the news media reports that the government has already advance-ordered pills for 1.7 million Americans, at a price of about $700 per patient, about a third the cost of a monoclonal antibody treatment.
In the following Q&A, Anderson comments on the outlook for molnupiravir, as well as other SARS-CoV-2 treatments emerging on the horizon.