Singapore inks deal for Merck antiviral pill to treat Covid-19

Oct 06, 2021

[SINGAPORE] The Republic has inked a supply and purchase agreement for an antiviral pill to treat Covid-19that is said to be effective against all known variants of the virus, including the Delta variant.

The drug was developed by pharmaceutical firm Merck & Co in the United States and Canada, which is also known as MSD elsewhere in the world, together with Miami-based Ridgeback Biotherapeutics. It will be available locally once it has received authorisation and approval for use, said MSD in an announcement on Wednesday (Oct 6).

The Straits Times has contacted the Ministry of Health for comment.

Known as molnupiravir, the drug comes in pill form and targets an enzyme that the virus needs to make copies of itself, by introducing errors into its genetic code.

This particular enzyme - known as the viral polymerase - is conserved across different variants, making molnupiravir effective across the Gamma, Delta and Mu variants.

Data from clinical trials suggests the drug is most effective when given early in the course of infection, said MSD.

Interim trial results last Friday showed it may reduce the chance of hospitalisation or death by half for patients who are at risk of severe disease.

The companies plan to seek US emergency use authorisation for the pill as soon as possible, and to submit applications to regulatory agencies worldwide.

"As the pandemic continues to evolve and surges are being reported in many places around the world, we are hopeful that we can make a meaningful impact on the pandemic through development of an effective oral antiviral that can be taken in earlier stages of disease, outside of hospitalised settings to limit disease progression," said Nick Kartsonis, senior vice-president, vaccines and infectious diseases, clinical research, MSD Research Laboratories.

So far, Australia has entered advanced supply agreements with MSD to purchase 300,000 courses of the drug.

Other countries like South Korea, Thailand, Taiwan and Malaysia are also in talks with the company to purchase the drug.

Commenting on the drug, Leong Hoe Nam, an infectious disease specialist at Rophi Clinic, Mount Elizabeth Novena Hospital, said: "It is a useful adjunct to the high vaccine coverage in Singapore. Very significantly, we can arm our frontline doctors with the oral medication that may make a difference at the point of diagnosis. This may shift treatment from hospitals to general practitioners and polyclinics as Singapore pivots towards endemic living with Covid-19."

Currently, molnupiravir is being evaluated as a Covid-19 treatment and as a preventative drug.

The treatment trial enrolled Covid-19 patients with mild to moderate Covid-19 who had symptoms for up to five days.

All of them had at least one risk factor associated with poor disease outcomes, including obesity, diabetes, heart disease and those aged above 60.

The trial results are expected in early November, said MSD.

In anticipation of the results, MSD expects to produce 10 million courses of treatment by the end of the year, with more doses to be produced next year.

The second trial, looking at molnupiravir as a preventative drug, will study the efficacy and safety of administering the drug to prevent the spread of Covid-19 within household settings.

Results are likely to be available in the first half of next year.

Local researchers had in their own study also identified molnupiravir as an effective drug against the original Sars-CoV-2 virus as well as the Beta and Delta variants.

A team led by Professor Dean Ho, director of the National University of Singapore's Institute for Digital Medicine, together with the DSO National Laboratories, found that molnupiravir, combined with baricitinib, an anti-inflammatory drug, could be a possible combination for Covid-19 treatment.

Prof Ho had told The Straits Times in August that both drugs come in a pill format and can therefore be administered to those with mild illness who are recovering at home, or in the community care setting.