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The innovations and scientific breakthroughs pertaining to battling the pandemic have been incredible. Numerous vaccines were developed in record time, and many involved new approaches to combatting viral infections. (Read about the race to create the coronavirus vaccines in this Bold story.) Likewise, complicated therapies like monoclonal antibodies were streamlined, allowing thousands to gain access to these important interventions. Despite these advances, many remain threatened by the COVID-19 virus, particularly older individuals and those with chronic illnesses. This is why recent reports concerning anti-COVID pills are attracting a great deal of excitement. The advantages that oral COVID medications could offer could be a game-changer in finally gaining control over the pandemic.

In recent weeks, two major pharmaceutical companies have announced favorable trial results involving oral COVID medications. Both Merck and Pfizer have their own types of anti-COVID pills that will likely be hitting the market soon. Given that these COVID treatment pills can be dispensed at pharmacies and taken at home, they offer much better accessibility to treatment. Plus, they can be taken after symptoms develop to reduce severity and complications. Certainly, vaccinations remain the best strategy at combatting the coronavirus to date. But having oral COVID medications as part of the arsenal in the pandemic fight represents an important turning point. Not only might this be the next stage of the battle, but it might finally mean the end of the pandemic is near.

“[Our anti-COVID pill] is a real game-changer in the global efforts to halt the devastation of this pandemic. These data suggest that our oral antiviral candidate, if approved or authorized by regulatory authorities, has the potential to save patients’ lives, reduce the severity of COVID-19 infections, and eliminate up to nine out of ten hospitalizations.” – Albert Bourla, CEO and Chairman, Pfizer

Anti-COVID Pills Show Impressive Results

In some ways, the search for oral COVID medications only started after the pandemic struck. The coronavirus served as a catalyst for change in many industries, and the pharmaceutical sector was certainly included. But the search for oral drugs to combat viruses is not necessarily new. In fact, Pfizer’s work in this area dates back 19 years during the SARS epidemic. This was further fueled by research to find more effective HIV therapies as well. Thus, the most recent discoveries involving anti-COVID pills simply required a shift in existing research protocols.

Understanding this, both Merck and Pfizer have recently announced impressive findings concerning oral COVID medications. Merck’s drug is named molnupiravir, and the company reports its use reduces the chance of hospitalization by 50%. Thus far, the medication has only been tested in high-risk patients who developed COVID symptoms. This included elderly, obese, and diabetic patients, and all began treatment within 5 days of symptom onset. Based on early results of the study, Merck halted further investigations and pursued regulatory approval for use. So far, Britain has already approved Merck’s pill and is moving forward with its use.

A bunch of anti-COVID pills just hanging out
Anti-COVID pills are the latest–and hopefully not the last–breakthrough in combating the virus.

In regards to Pfizer, its research into anti-COVID pills is even more promising. After studying 1,200 high-risk patients with COVID symptoms, their formulation, paxlovid, reduced hospitalization by 89%. For these individuals who took it within 3 days of symptom onset, the course of the illness was much milder. Pfizer, like Merck, also stopped their study early because of the impressive results seen. It is now also seeking regulatory approval in numerous countries throughout the world as well.

“Once we get through this delta wave of infection over the course of the next two months, I think that this therapeutic and the other innovations that we’ve seen coming to market really mark the end of the pandemic in the United States.” – Scott Gottlieb, Former U.S. Food and Drug Administration Commissioner

Practical Issues with Anti-COVID Pills

In terms of administration, both oral COVID medications are quite similar. Notably, both work by slowing down the replication of the virus. This allows fewer symptoms and a longer period of time for the body to fight off the infection. For Pfizer, 30 pills of paxlovid are administered over a 5-day period. Its administration, however, also includes 10 pills of the HIV drug, ritonavir. This medication is added because it prolonged the action of paxlovid according to researchers. For Merck, 40 pills of molnupiravir are taken also over a 5-day period, and it doesn’t include adjunctive medications. And for both anti-COVID pills, the cost of a course of treatment is around $700. While this certainly isn’t cheap, it is much less expensive when compared to monoclonal antibody therapies. (Dive deeper into this post-COVID infection treatment in this Bold story!)

As with any new medication, there is always concerns about side effects and safety. For both of these new oral COVID medications, however, safety profiles to date look favorable. Both Merck and Pfizer reported that patients receiving their anti-COVID pills had fewer complaints when compared to those taking placebo. This suggests that the positive effect on COVID symptoms as well as any side effects were less than COVID symptoms by themselves. Some critics, however, are concerned with Merck’s medication because it works by inserting genetic errors into the coronavirus itself. They are worried such a mechanism of action might lead to unwanted viral mutations. Pfizer’s medication doesn’t involve genetic alterations, and therefore, it has not received the same criticism.

Coming to a Pharmacy Near You

As noted, both Merck and Pfizer are actively seeking regulatory approval in numerous countries for their oral COVID medications. The U.S. already ordered 1.7 million doses of molnupiravir and is negotiating an order for the same amount of paxlovid. For low-income nations, these companies are also working with the UN’s nonprofit, Medicine Patent Pool. This will allow other countries to manufacture the anti-COVID pills and receive medication at reduced costs. In terms of production, Pfizer expects to have 180,000 courses available for use by year’s end. They then anticipated 21 millions courses by mid-2022. Thus, it’s clear that these oral COVID medications will soon be available for routine use. This is great news for everyone and offers great hope that the end of the pandemic may well be in sight.

 

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