With $1.2B deal for molnupiravir, U.S. bets on Merck's oral COVID-19 antiviral

Merck has struggled to develop therapeutics and vaccines to fight COVID-19. But the United States is betting that the pharmaceutical giant at last has a winner in its oral antiviral molnupiravir.

On Wednesday Merck revealed a deal to supply 1.7 million courses of the experimental treatment to the U.S. for approximately $1.2 billion. Molnupiravir has yet to be approved, but it's shown promise for newly diagnosed, non-hospitalized COVID-19 patients.

The drug, developed in collaboration with Ridgeback Biotherapeutics, is in phase 3 testing. With positive results, Merck expects to apply for emergency authorization later this year.   

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Molnupiravir is taken in pill form every 12 hours for five days; a course consists of 10 pills. The company said it expects to have more than 10 million courses of the treatment available by the end of the year.

On top of the U.S. deal, Merck is "actively engaged in numerous efforts to make molnupiravir available globally,” company president Rob Davis said in a statement.

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Molnupiravir is Merck’s last-ditch effort at developing a COVID-19 countermeasure. In January, the company said it was scrapping two experimental COVID vaccines after data showed disappointing immune responses. 

Merck also took an unsuccessful gamble on a drug for hospitalized COVID-19 patients, the biological immunomodulator MK-7110. The company acquired the treatment in a $425 million buyout of Oncolmmune last November but halted its development after the FDA asked the company for more data. With that decision, the company voided a $356 million supply deal with the U.S. 

But the drug giant has also had its struggles with molnupiravir. The company stopped development of the medicine for hospitalized COVID-19 patients in April after mid-stage data showed the drug wouldn't likely demonstrate clinical benefit in those patients.

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Afterward, Merck altered its game-plan when the drug showed benefits in patients enrolled within five days of symptom onset. If approved, molnupiravir would fill a gap in the COVID-19 treatment toolkit as a simple way of reducing risk of disease progression for those recently infected.

Editor's note: This story was corrected to reflect that MK-7110 did not fail its phase 3 trial in COVID-19, but rather that the FDA requested more data on the medicine, prompting Merck to discontinue development.