Nearly £1bn spent on anti-Covid drug makes ‘no significant difference’

Molnupiravir - Jennifer Lorenzini/Reuters

Molnupiravir – Jennifer Lorenzini/Reuters

Nearly £1bn of taxpayers’ money has been wasted on an anti-Covid drug that “makes no significant difference”, The Telegraph can reveal.

Less than two percent of the 2.23 million courses of the antiviral drug molnupiravir purchased by the Department of Health have ever been prescribed to patients, according to analysis by The Telegraph.

It’s unlikely the rest will ever be used after research shows the drug makes “no significant difference” to hospitalization or death rates.

The National Institute for Health and Care Excellence (Nice), the UK’s drug watchdog, recently said molnupiravir should not be used routinely. In November, the drug was added to the tentative “not recommended” list for the treatment of Covid.

The drug is much more expensive than alternatives, at around £450 per course. It has been so little used that it costs £30,000 per patient treated, The Telegraph investigation reveals.

In the fall of 2021, Sajid Javid, then Health Minister, announced that the government had bought 2.23 million courses of the “pioneering” antiviral in an effort to reduce the impact of the omicron variant.

The UK was the first country in the world to authorize molnupiravir, which was designed to keep vulnerable people out of hospital by reducing the severity of Covid symptoms. At the time, Mr Javid described the decision as a “historic day”.

Prescription data shows that a total of just 20,195 courses of the drug were prescribed between December 2021 and the end of last week.

In addition, nearly 13,000 courses were prescribed during the drug’s main clinical trial in the UK. As a result, only 33,000 doses have been used in total, leaving about 98 percent of the total courses obtained.

The drug expires 30 months from the date of manufacture, which means that products manufactured by the end of 2021 must be destroyed from mid-2024.

Nice’s move to say the drug was not recommended followed early findings from the Oxford University-led panoramic study involving more than 25,000 people. This found “no significant difference” in death rates or hospitalizations between patients treated with the drug and those receiving standard care.

Studies have shown that similar drugs, such as the steroid budesonide, have the same effect, but cost just £15 per course, compared to around £450 for molnupiravir.

When the government first bought the drug, it made the decision based on the preliminary results of a much smaller trial of 762 patients conducted by the manufacturer, which suggested it reduced hospitalizations by 50 percent.

However, the second half of that study, known as the move-out trial, suggested the drug was linked to a 25 percent increase in hospitalizations.

The results finally published showed an overall benefit of a reduction in hospitalizations of up to 30 percent, although an independent analysis of the results by pharmacology expert Dr Andrew Hill’s team showed that this may not have been statistically significant.

Overall, the combined results of both the panoramic and relocation studies showed that molnupiravir had no effect on reducing hospitalizations, the BMJ reported.

‘Decisions had to be made in real time’

Last year France canceled its contracts for molnupiravir, while in Australia – where it was the most commonly prescribed anti-Covid medication – advice was updated to say the drug “should not be used routinely”. Health authorities in the US have recommended using it “only as a last resort”.

Britain’s drug regulator, the Medicines and Healthcare Regulatory Products Agency, which approved the use of the drug in November 2021, said it was still under review.

Last month, early findings from a UK-led study suggested that molnupiravir may actually cause the Covid virus to mutate, giving rise to new variants. The manufacturers disputed this claim.

Dr. Hill, a senior visiting researcher at the University of Liverpool, said it is likely that nearly £1bn was lost on the drug, manufactured by US-based pharma giant Merck Sharp and Dohme.

Dr. Hill said: “Decisions had to be made in real time during the pandemic. The UK government was quick to approve vaccines – and it turned out – but it wasn’t right about everything. Money was wasted as we just bought [medicines] expecting them to work.

“It is very difficult for people working in a pandemic to make the right decisions, but you would think now is the time to reevaluate. [Recent research suggests] there is a chance it will cause damage.”

‘Benefits continue to outweigh risks’

A Ministry of Health spokesman said: “We have taken swift action in light of Omicron to secure a supply of oral antivirals to support the national response at a time of uncertainty. The impact of omicron is less severe than previous variants and our vaccination program has been successful in protecting people from serious illness, hospitalization and death.

“Molnupiravir will continue to be available to at-risk patients this winter, alongside other medications, free testing and vaccinations, to reduce the risk of hospitalization and improve recovery for the most vulnerable.”

The MHRA said: “Molnupiravir (Lagevrio) has received a conditional marketing authorization and is under further review as new data emerge. The benefits of molnupiravir continue to outweigh the risks in the treatment of Covid, although the population with the most benefit may need further refinement as more data is collected.

A spokesperson for Merck Sharp and Dohme said the company was “deeply disappointed” by Nice’s decision to advise against using the drug in its draft recommendations.

“We are concerned that the methodology used to make this decision has not been able to provide a full assessment of the value Covid antiviral treatments provide,” said a spokesperson, adding that the assessment is based on was on the number of hospitalizations during the Omicron wave rather than during the trial period, when several variants were in circulation.

The company said it was confident in the drug’s clinical profile and analysis of the latest data.

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