Why is Pfizer’s COVID-19 pill not being used more? – 7 day supply – MM + M

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Pfizer’s COVID-19 pill data caused a sensation last week, helping the drugmaker win an 89% to 50% effectiveness showdown against rival Merck’s own offer. Yet Pfizer overtook Merck in another area: media mentions.

Although roughly half as effective, according to interim results shared by the companies, Merck’s molnupiravir data must have impressed more journalists, editors and producers than the Pfizer candidate. It garnered almost 50% more media mentions.

“There is clearly an advantage to being the first one, and that’s what media data tells you more than anything,” said Zack Jenkins, SVP, Sales and Account Management at media Intel Firm. Critical Mention.

Indeed, Merck was the first to walk out the door with the news of an effective oral antiviral. His October 1 announcement has shown that its nucleoside analog halves the risk of dying or being hospitalized for COVID-19 patients at high risk of serious illness. November 5, Pfizer said that its protease inhibitor, which will be sold under the brand name Paxlovid, reduced the risk of hospitalization or death by 89% for adults at risk of serious disease.

“At first glance, I would say the protease inhibitor approach, which is co-administered with ritonavir, appears to be the best drug,” said Dr Paul Auwaerter, Clinical Director, Division of Infectious Diseases and Professor of Medicine, Johns Hopkins School of Medicine. (He did not participate in either of the two studies.)

What made his reception calmer among the confusing journalists. Over a two-week period covering each side of the October 1 press release, mentions of terms like “molnupiravir” in mainstream media, as well as “Merck”, “antiviral” or “COVID”, generated 50% of visits more than comparable mentions. for the Pfizer candidate (33,698 for Merck versus 21,922 for Pfizer), according to Critical Mention data.

Content reviewed included TV, radio, podcasts, online news, and print media, but not Facebook or YouTube. Advertising value – the amount it would take to reach an equivalent audience in terms of paid advertising – was also around 50% higher for Merck (see charts).

Some of these differences can be attributed to the nuances between the pills. Paxlovid – or ‘332, as the candidate is known in medical circles – is a so-called synthetic drug, developed last summer.

The drug works by inhibiting the virus replication process and needs to be reinforced with ritonavir, another antiviral. The Pfizer Phase 2/3 trial showed that side effects were much lower in the active arm compared to placebo, which is encouraging, although ritonavir has the potential to interfere with other drugs that ‘a patient can take.

Molnupiravir, which works by interfering with the virus’s RNA, is a pre-existing molecule known to scientists to have antiviral activity. Although some may call it a standard drug, it has never been approved and has never been used in any country. (This changed last week when the UK authorized based on preliminary data).

Infectious disease specialists, Auwaerter explained, have been reluctant to use molnupiravir to treat Ebola virus or hepatitis C due to concerns that its short half-life could lead to resistance. Likewise, since nucleoside analogs work by causing the virus to develop mutations in its RNA, there is concern that it could potentially cause mutagenesis in human DNA.

This is one of the reasons the drug would likely not be recommended for use in pregnant women or anyone planning to become pregnant in the near future, Auwaerter warned. “At least in the scientific community, there has been a bit more hesitation because this drug has been around for some time.”

Nonetheless, when it looked like Merck would be the first to market an effective oral antiviral for COVID-19 – especially compared to the litany of oral medications that have been tried, such as hydroxychloroquine, ivermectin and fluvoxamine – journalists jumped on the story.

Eric Lebowitz, vice president of marketing for Critical Mention, said educating journalists could have made a difference. “It is difficult to know what the strategies of the two companies are and their relationship with journalists, but it is certainly possible,” he noted.

Both companies have prematurely stopped trials of their drugs thanks to the positive results. Merck said it will submit its Phase 3 data to the FDA on November 30 and plans to seek emergency approval as soon as possible. Pfizer, for its part, said it plans to submit provisional data to the FDA by Nov. 25 and that its pill could gain approval by the end of the year. The US government has already pledged to buy millions of doses of each.

The pills could give doctors a head start in rolling back the pandemic. Currently, the only therapies approved for outpatient treatment of COVID-19, at least in the United States, are monoclonal antibody therapies. Their ability to prevent hospitalization or death is around 80% to 85%, Auwaerter said, adding that Paxlovid is “very similar to that based on this trial alone.”

Meanwhile, due to its superior side effect profile, Paxlovid could be used without a confirmed diagnosis of COVID-19 “as long as you are not concerned that ritonavir may interact with other drugs someone is taking.” noted Auwaerter.

Much like Roche’s prescription for Tamiflu for the flu, it would be “a huge benefit to getting a strong antiviral on board early on, especially for high-risk patients,” he continued. “If this drug could be widely manufactured and prescribed after the vaccine and were easier to distribute, it could potentially help, especially in countries that may not have rapid diagnoses. “

That said, Pfizer and Merck could end up seeing a bargain from their pills. As with any antiviral, if a drug is used a lot, there is always a potential for resistance, especially when using only one drug.

said Auwaerter, There have been people who wonder if drugs [‘332 and molnupiravir] should be used together to avoid a potential emergence of mutations.


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