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Health Ministry approves Merck’s anti-COVID pill, the second okayed in Israel

First shipment expected to arrive in coming days; ministry doesn’t specify numbers or price but report says there will be enough for several thousand treatments at $700 a pop

Merck antiviral medication molnupiravir. (Merck & Co. via AP, File)
Merck antiviral medication molnupiravir. (Merck & Co. via AP, File)

The Health Ministry announced Sunday that it has approved Merck’s anti-COVID pill, less than two weeks after the US Food and Drug Administration approved the medication for use.

The ministry said it inked a deal with Merck to purchase molnupiravir, which is being sold under the name Lagevrio, with the first shipment expected to arrive in the coming days. It didn’t specify how many pills it agreed to buy.

A source told the Kan public broadcaster that enough pills were bought to treat several thousand patients, with an option to purchase more. The price tag is estimated to be around $700 per patient treatment, according to the report, which would make it more expensive than a similar medicine offered by Pfizer, also purchased by Israel.

Merck’s pill is less effective at treating COVID than Pfizer’s. It is taken within five days of symptom onset and was shown in a trial of 1,400 participants to reduce COVID hospitalizations and deaths by 30 percent among at-risk people.

Pfizer’s pill reduced the same outcomes by almost 90%, is authorized for people aged 12 and up, and has fewer overall safety concerns.

Overall, while both treatments were found to be generally well-tolerated in clinical trials, more potential concerns have been raised about Merck’s pill.

The FDA has not authorized Merck’s pill for people under 18 because it may affect bone and cartilage growth. It is also not recommended for use in pregnant women because of the potential for fetal harm, which was identified in animal testing, but doctors can still decide if the benefits outweigh the risks in individual cases.

Independent experts convened by the FDA narrowly voted in favor of authorizing molnupiravir in early December. Several who voted “no” highlighted these potential risks.

In its authorization letter, the FDA stressed it should be taken only when other options are either not available or not appropriate.

Pfizer’s treatment can cause adverse reactions if mixed with certain other medications, and isn’t recommended for people with severe kidney or liver impairment.

Initial data about molnupiravir’s efficacy was more encouraging, suggesting a 50% reduction in severe COVID, but that figure was later downgraded to 30% after the final analysis included more cases.

Eight capsules of molnupiravir are taken orally for five days, for a total of 40 capsules.

The molecule works by incorporating itself into the genome of the virus, causing mutations that prevent viral replication.

The drug has previously been authorized in Britain and Denmark.

The first shipment of Pfizer’s Paxlovid pills is seen being offloaded from a plane at Ben Gurion Airport, December 30, 2021. (Courtesy)

Last Thursday the first shipment of Pfizer’s pill arrived in Israel, one of the first countries in the world to receive the drug, known as Paxlovid.

The delivery consisted of several tens of thousands of pills. The medication is said to cost the country around $530 per patient.

Israel’s Health Ministry granted emergency approval to the Pfizer medication on Sunday, a week after the US Federal Drug Administration (FDA) did the same.

Army Radio said Thursday that Israel is also in negotiation with AstraZeneca over the purchase of its new COVID-19 antibody drug.

Pills that can be picked up at pharmacies following a prescription should be a major boost to health care systems in the fight against COVID.

Because the pills do not target the ever-mutating spike protein that dots the virus’s surface, they should be variant-proof. The companies have said early lab testing against Omicron have borne this out.

Israel’s rush to obtain COVID treatment pills comes as the highly infectious Omicron variant has rapidly driven up morbidity in what is now the country’s fifth wave of coronavirus.

Health care workers take test samples in COVID-19 testing complex in Ma’ale Adumim, on December 30, 2021. (Yonatan Sindel/Flash90)

Health Ministry figures published Sunday morning showed that 4,197 new cases were confirmed on Saturday, a figure affected by reduced testing on weekends, with the rate of positive tests rising to 4.57 percent. Daily new infections in Israel have spiked from under 1,000 new cases some 10 days ago to almost 5,500 on Friday, and active cases have almost tripled in a week to 31,958. The total confirmed infections since the start of the pandemic stand at close to 1.4 million.

However, serious cases have seen a far more moderate increase, from 77 on December 22 to 110 on Sunday. The death toll remained at 8,244. There have been four COVID-related deaths in the country since December 21.

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