Hong Kong looking to procure molnupiravir, world’s first COVID-19 pill

Victor Ting and Elizabeth Cheung, South China Morning Post

Posted at Oct 03 2021 09:15 AM

An experimental COVID-19 treatment pill, called Molnupiravir being developed by Merck & Co Inc and Ridgeback Biotherapeutics LP, is seen in this undated handout photo released by. Merck & Co Inc/handout via Reuters
An experimental COVID-19 treatment pill, called Molnupiravir being developed by Merck & Co Inc and Ridgeback Biotherapeutics LP, is seen in this undated handout photo released by. Merck & Co Inc/handout via Reuters

Hong Kong is in the process of securing the world's first Covid-19 pill, which the manufacturers claim can cut hospitalisations and deaths by half.

Sources told the Post that health authorities planned to buy hundreds of courses of the antiviral medication, which made headlines on Friday after pharmaceutical giant MSD and its partner Ridgeback Biotherapeutics released promising results from their trials.

The trials involved 775 adults with mild to moderate Covid-19 who were randomly picked from more than 20 countries and deemed to be highly prone to severe illness due to health problems such as obesity, diabetes or heart disease.

Half of the trial participants were given a five-day course of the experimental drug, known as molnupiravir, in the form of small, brown capsules taken twice a day, while the others received a placebo. According to the results, only 28 patients, or 7.3 per cent, of those given the drug were hospitalised, compared with 53, or 14.1 per cent, in the placebo group.

After the trial, no deaths were reported among those who received the drug, while the placebo group had eight. The data, however, has not been peer-reviewed and the drug has not yet been licensed for use.

Three medical sources confirmed to the Post that Hong Kong was looking to procure the medication.

"The Hospital Authority plans to purchase 500 patient courses, but they are also thinking about more," Professor David Hui Shu-cheong, a government pandemic adviser, said on Saturday.

He revealed that the drug costs about US$700 per course for each patient.

Hui and other authority doctors said they hoped the matter would be discussed at the next meeting of the Centre for Health Protection's joint scientific committees, which was likely to take place in late October or early November.

Another source familiar with the matter said negotiations between MSD, which trades as Merck in North America, and the authority were continuing and that "no paperwork has been signed" yet.

A third source said the drug could be approved for emergency use to treat severely ill patients although it was not yet licensed by local health authorities.

"It would, however, be difficult to conduct any local study on its effectiveness, as we fortunately have so few patients in the community, and most imported cases have a low viral load," the health expert said.

Infectious disease expert Professor Ivan Hung Fan-ngai, who has looked at the trial data, said molnupiravir achieved the best results with a daily dosage of 800 milligrams given in the first week of illness, rather than lower amounts of 400 or 200 milligrams.

"It works best when given early and results in fewer hospitalisations and deaths subsequently," he said.

Hung, who co-chairs a government panel on adverse vaccine effects, noted the city's cocktail therapy for Covid-19 centred on the antiviral interferon, which also achieved its best results when given early.

"In general, early treatment is the key to success for all antivirals," he said.

A Hospital Authority source said it had been monitoring the drug's development.

"It has been on our radar all along, but we can't say how the company will distribute the drug globally," the source said, noting that US authorities had yet to authorise the pill for emergency use.

An authority spokesman said its experts had been closely monitoring the latest developments in the pandemic and clinical research. It would buy and stock medications for Covid-19 when necessary, after taking reference from the latest data from worldwide drug regulatory agencies and manufacturers.

The authority would ensure patients were prescribed new medications that were proven safe and effective, the spokesman said.

The Department of Health said it had not received any application for the registration of molnupiravir. Under the Pharmacy and Poisons Ordinance, doctors can import drugs that are not yet registered in the city for treating specific patients or conducting clinical trials.

MSD said it would apply for approval for emergency use for the drug in the United States within the next two weeks and make applications in several other countries as well.

The Post has contacted the drugmaker for comment.

Copyright (c) 2021. South China Morning Post Publishers Ltd. All rights reserved.


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