Health authorities in Fiji say they are concerned about an anti-viral pill designed to treat symptomatic Covid-19.
Molnupiravir is the first oral antiviral treatment for Covid to report clinical trial results. Photo: Merck
The Molnupiravir tablet is manufactured by American pharmaceutical giant Merck and has been approved by the UK medicines regulator.
The pill cuts the risk of hospitalisation or death by about half in vulnerable adults, clinical trial results suggest.
But Fiji's Health Secretary James Fong said they are concerned about the safety and cost of the drug.
Dr Fong said an earlier study, using Molnupiravir in patients severe enough to be admitted into hospital, showed no benefit.
"The news about Molnupiravir is undoubtedly exciting," Dr Fong said. "Based on a small randomised trial of 775 patients, the drug showed up to 50 percent capability in reducing severe disease and death when given at the onset of infection."
Dr Fong said unlike other potential Covid treatments, the pill was taken as a five-day course on an outpatient basis.
"For Fiji, having a therapeutic drug like this would be ideal but we will need to educate people on its use as it has to be used at the onset of mild to moderate disease, when symptomatic self-care is appropriate.
"As such, this drug will need to be so cheap and so safe that it can be used widely in the community.
"At the moment it is quite costly although I am aware of initiatives being taken to make it more affordable."
Dr Fong also said there were concerns about the drug's safety because it worked by causing mutations in the virus.
"Although it is a potential game-changer for Covid-19 and probably other viral treatment, we need to see more details of the study itself and the peer-reviewed publication is not widely available."
Permanent Secretary for Health, Dr James Fong Photo: Fiji govt
Dr Fong said the Pfizer pill was used with an older antiviral drug called Ritonavir and had reported a 90 percent reduction in severe disease and hospitalisation when used by persons with mild to moderate disease.
"In essence, both the Merck and Pfizer pills will work well in settings where health-seeking behaviour is at an optimal level.
"We are making preliminary explorations on how we can access stocks and as they represent a good home-based therapeutic option for those with mild to moderate disease."
Fiji had planned to order drug to combat third Covid wave
Fiji had earlier planned to purchase the Molnupiravir as a safeguard against a possible third wave of Covid-19, Dr Fong said.
Fiji was aware of the orally administered antiviral drug and was investigating the possibility of acquiring it, he added.
"We were also looking to purchase for the expected third wave."
Dr Fong could not say whether the availability of the tablet would bring to a halt Fiji's current vaccination campaign.
Close to 90 percent (88.5 percent) of Fiji's adult population have been fully vaccinated, while about 21,000 of children aged 12-17 have received both jabs.
Fiji has 940 active cases of Covid-19 with 675 deaths reported since the pandemic started in March 2021, while 673 of the victims died during the outbreak in April this year.
There has been a total of 52,298 cases in Fiji since March 2021, 52,227 of them were from April's outbreak.
Photo: AFP
Mission to 'save and improve lives'
Merck announced that the UK Medicines and Healthcare products Regulatory Agency (MHRA) had granted authorisation for Molnupiravir, as the first oral antiviral medicine for the treatment of mild-to-moderate Covid-19 in adults (with a positive Covid diagnostic test), and who have at least one risk factor for developing severe illness.
In a statement, Merck CEO and president Robert Davis said in pursuit of the company's "unwavering mission to save and improve lives", it would continue to "move with both rigour and urgency to bring Molnupiravir to patients around the world as quickly as possible".
"As an oral therapeutic, Molnupiravir offers an important addition to the vaccines and medicines deployed so far to counter the Covid-19 pandemic."
Merck announced preliminary results last month which showed the drug cut hospitalisations and deaths by half among patients with early Covid-19 symptoms.
The results have not been vetted by outside scientists and the company also did not disclose details on its side effects, except to say that rates of those problems were similar between people who got the drug and those who received dummy pills.
While the UK is the first country to approve Molnupiravir, US advisers are expected to meet this month to vote on whether it should be authorised.
Australia's Therapeutic Goods Administration has not approved the drug but Prime Minister Scott Morrison announced in an October 5 statement that his government had secured a deal to purchase 300,000 courses of Molnupiravir.
The US has made an advance purchase of $1.2 billion worth of Molnupiravir - about 1.7 million treatments along with Singapore and South Korea who have also made purchase agreements.
Molnupiravir is one of two antiviral pills for people with mild to moderate symptoms of Covid.
The other is the Pfizer's Paxlovid pill, which it said could cut the risk of hospitalization and death from the disease by 89 percent in high-risk adults.
