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Merck’s COVID-19 pill may soon be here. How well will it work?

Hopes for an easy pill that could combat COVID-19 before people land in the hospital have dimmed a bit. New data about an antiviral pill made by Merck with its partner Ridgeback Pharmaceuticals show it’s not as stellar as first believed. And the drug has drawbacks that could outweigh its potential to fight the coronavirus and keep people out of the hospital.

The U.S. Food and Drug Administration is now weighing whether to grant emergency use authorization for the drug, called molnupiravir, after the agency’s advisory panel narrowly voted to recommend it on November 30. The drug was authorized for use in the United Kingdom on November 4. If the FDA follows suit, it could wind up being just a stopgap: Some advisers already have urged the agency to be ready to withdraw that authorization as soon as something better comes along.

Finding an early treatment hasn’t been easy, so many experts initially hailed the development of molnupiravir as a potential game changer for the pandemic: A pill that could be given to people early in the infection might help keep health care systems from being overwhelmed, and spare people at high risk from the most severe complications (SN: 7/27/21).

In a clinical trial, the drug showed early signs of preventing hospitalization and death from COVID-19 in people at high risk of severe disease (SN: 10/1/21). In fact, the results were so promising — a 48 percent reduction in the relative risk of hospitalization or death — that the trial was stopped so that the drug might potentially reach the public earlier.

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