November 29, 2021

UNDERSTAND EVERYTHING – What is molnupiravir, the anti-Covid pill ordered by France?

Tuesday, Olivier Véran announced the order for 50,000 anti-Covid pills that the American laboratory Merck has just made available, pending possible marketing authorizations. reviews the information available on this processing.

It could be the missing link so far in the anti-Covid-19 arsenal. Olivier Véran thus announced on Tuesday the order by France of 50,000 molnupiravir pills produced in the laboratories of the American company Merck (MSD). A sign of the hope aroused by this drug, the order did not wait for the end of the evaluations launched by the international health authorities.

“50,000 doses of this drug will be delivered to France from the last days of November or the first days of December, that is to say as soon as the treatments leave the production lines”, explained the Minister of Health during a hearing before the senators.

While many dimensions linked to this new pharmaceutical company remain unknown, here is what we know about its operation and effectiveness.

· What is molnupiravir supposed to be used for?

We must first twist our necks to a possible misunderstanding. Molnupiravir does not claim to provide preventive treatment for the disease. Its objectives lie elsewhere: it is supposed to “reduce the serious forms, the duration of the disease”, enlightened this Wednesday on BFMTV Bruno Lina, professor of virology at the Hospices Civiles de Lyon, member of the Scientific Council.

More specifically, the drug aims to reduce hospital admissions and lower the virality of the virus. “The great benefit of this treatment is that it is also effective on variants,” Jacques Zagury, director of communications for MSD France, told BFMTV.

So it will be a matter of administering it in the aftermath, after contamination, and not to protect against disease. On the other hand, it will be necessary to ingest the pill as soon as possible. “It is a treatment which can have an interest when it is given very early in the disease”, continued Bruno Lina who illustrated:

“This is the principle of ‘screened-treated’. From the moment you have a positive test, the treatment must be administered as quickly as possible because it is effective at the virological stage of the disease.”

By definition, being a pill, the primary virtue of molnupiravir is the ease of its mode of administration: the oral route. Once swallowed, the medicine will try to counteract the disease.

The professor in virology Bruno Lina described its action: “It is a polymerase inhibitor”, that is to say “a product which will block the functioning of the protein of the virus which is in charge of the multiplication of the virus”.

In other words, the principle of treatment will hinder the famous spike protein which allows Covid-19 to enter and proliferate cells.

· What do we know about the effectiveness of molnupiravir?

The issue of clinical trials is all the more critical given that many segments of the population base their concerns or even their hostility towards vaccines on the speed of their production and the supposed opacity of their development.

Regarding molnupiravir, Merck “has just announced at the beginning of October the first results of the phase 3 trial”, recalled Jacques Zagury, communications director of MSD France. The drug has so far been tested in 800 patients, who so far presented “mild to moderate forms of the disease”.

The laboratory claims “a 50% reduction in the risk of hospitalizations and death when patients are treated with Molnupiravir”, but has yet to release details of these trials.

A crucial step still stands before the marketing authorization of the product: its validation by the health authorities. “Now, we are in the discussion phase with the health authorities, in particular at European level where the authorities have all the information on the product and this is being evaluated”, acknowledged Jacques Zagury.

He continued: “We hope that we are talking about a few weeks to a few months, to make the treatment available to patients by the end of the year in France”. “It could be that some authorities go faster than others but it will play in a pocket handkerchief since all the authorities are currently evaluating the data,” added the communications director of MSD France.

· Where will the medicine be available?

France has already ordered 50,000 pills. The United States struck even harder, buying 1.7 million doses. In addition to these two orders, Merck is targeting distribution in “a hundred” countries, says Jacques Zagury to our branch on Wednesday. Distribution conditional of course on evaluations initiated by the health authorities mentioned above.

The American company insists on its fair distribution around the world. Jacques Zagury tried to give weight to this good intention via an example, announcing that an agreement had already been concluded with India for a “low cost” production of the pill for this country. “All countries with the same level of income will have the same price,” he promised.

· How much will it cost?

Here we come to the question of the portfolio. No official price has yet been decided and no grid has been revealed – since the price of the drug will vary according to the regions of the world. However, one element allows us to get an idea of ​​its cost: my United States paid $ 1.2 billion for 1.7 billion capsules, or 700 dollars per unit, or 600 euros.

So delivered, there is something exorbitant about the amount. However, the daily economic realities governing the field of health must be more nuanced. In any case, this is the invitation launched to BFMTV by Frédéric Bizard, an economist specializing in social protection and health issues: “It is a cost-benefit calculation. If we look at the cost of hospitalization – 1500 euros per day – we see that the 600 euros unit cost of this drug is interesting for the States. ” Olivier Véran did not specify the amount of the French order.

Robin Verner BFMTV reporter