The curious case of molnupiravir

By now, many Filipinos have heard of molnupiravir, the new antiviral medication that is being described as a “game-changer” in the fight against COVID-19. It was reported to reduce the risk of hospitalization in patients with mild to moderate COVID-19 by 50 percent in interim phase III clinical trials, and is currently being evaluated for inclusion into the World Health Organization (WHO) living guideline on COVID-19 therapeutics while pending authorization for its use from regulatory bodies. If approved, it will be the first oral pill that people can take at home to keep from getting sick enough to end up in the hospital or die.

Those results alone should be enough for anyone with common sense and a basic understanding of probability to jump at the chance to have access to this drug – which is why MSD (the 1953 merger of Merck Pharmaceuticals’ scientific research and Sharpe & Dohme’s marketing expertise, making it the first real case of “Big Pharma”) predicts it can make between five to seven billion dollars in sales of molnupiravir in 2022, according to company representatives on a recent Earnings call with Wall Street analysts.

A five-day course of molnupiravir allegedly costs $17.74 to produce, according to a report by drug pricing experts from the Harvard School of Public Health and King’s College Hospital in London. Merck is charging the US government $713 for the same amount of medicine – 40 times the price of what it cost to make.

This likely prompted the Medicines Patent Pool (MPP) to lobby for (and eventually win as of the end of October) a voluntary licensing agreement with MSD to facilitate affordable access to molnupiravir. The MPP is a United Nations (UN)-backed public health organization working to increase access to, and facilitate the development of, life-saving medicines for low- and middle-income countries.

With the WHO (and the UN itself) backing increased access to this drug, one wonders why the Philippine Food and Drug Administration (FDA) appears to be less than excited for Filipinos to have access to molnupiravir, especially since we have the opportunity to avail of the same medicine made in the Philippines.

In Quezon City, there is an EU-GMP compliant manufacturing facility and a local drug manufacturer that has been around since 1989 – one that is considered a leader in the pharmaceutical manufacturing industry across the globe. The company undertakes the manufacture of, among other things, capsules – the very delivery system molnupiravir requires. It has the ability to manufacture, as well as the technology and ingredients needed to make this drug in the Philippines – drastically reducing costs to the Filipino consumer. (To be continued)