UC Davis Health infectious diseases expert answers common questions about Merck’s new COVID-19 treatment
A new COVID-19 treatment that could be given in the days after COVID-19 symptoms arise to prevent severe disease has been developed by Merck & Co.
The treatment would be the first pill shown to treat COVID-19. Studies have shown it reduces hospitalizations and deaths by half in people recently infected with the coronavirus.
Merck has applied to the Food and Drug Administration (FDA) for emergency use authorization (EUA) of the pill, called molnupiravir. An advisory committee is scheduled to evaluate the safety and efficacy data of the pill on Nov. 30 and decide whether to approve it for EUA in the United States.
How does Merck's COVID-19 treatment pill work?
It works just like most antivirals by inhibiting the ability of the SARS-CoV-2 virus to replicate. The hope is that we can treat COVID-19 the way we do influenza with Tamiflu, the antiviral medication used to prevent serious flu symptoms.
When it is FDA-approved, a physician could prescribe patients the pill following the development of infection. Taking the pill early can help the patients improve faster.
What makes Merck's pill different from other COVID-19 treatments?
Currently, all COVID-19 therapies now authorized in the United States require an IV or injection, requiring patients to be in the hospital or an infusion center. As an example, monoclonal antibody treatments are given to patients through an IV infusion or injection, so they need to come to a clinic or hospital.
What makes Merck’s pill unique is that a patient's primary care doctor can prescribe it, they can pick it up later that day, and start their treatment at home. This could alleviate some of the capacity issues impacting hospitals across the country.
Who will be eligible to receive Merck's pill if it is approved?
For almost anyone over 18 years old, this could be a potential treatment option for COVID-19. High-risk adults, people 60 and over or those who are younger but have conditions that put them at high risk of bad outcomes from COVID-19, may benefit the most.
One group Merck did not test the drug on were pregnant women, so they likely would not be eligible for the treatment at this time.
When would it be best to start taking Merck's pill?
With the doctor's approval, patients should start taking the pill as soon as they test positive for COVID-19. The earlier a patient receives an antiviral, the more effective it will likely be.
Starting a medication a little bit later can diminish the efficacy of the treatment, because your body is fighting it off already. In some severe cases of COVID-19, the virus may be gone, but it's the immune system's response that causes some of the long-term problems.
If Merck's pill is authorized, do we still need vaccines?
Yes, we still need everyone vaccinated.
No matter what antivirals are developed, viruses will develop resistance. So, if we continue to allow COVID-19 to spread throughout the community, some strains will develop resistance based on what we have seen with other viral infections.
Merck is allowing drug makers in other countries to make its COVID-19 pill. Why is this important?
I think this will really increase the amount of the treatment available and bring down the costs as well. Mainly, it increases the availability to people that might need it, especially in poorer countries. The more we curb the spread of COVID-19 throughout the globe, the less it will replicate and make this treatment more effective.