Khairy: No Upfront Payment For MSD’s Covid-19 Pill

Khairy Jamaluddin says triggering the contract will only take place after regulatory approval; the UK has authorised Merck’s Covid-19 pill, molnupiravir.

KUALA LUMPUR, Nov 5 — The government’s agreement to procure a Covid-19 oral antiviral medicine from Merck Sharp & Dohme (MSD) does not require an upfront payment, according to Health Minister Khairy Jamaluddin.

The United Kingdom was the first country to grant conditional authorisation yesterday to Merck’s molnupiravir, a 40-pill course of treatment for patients with mild-to-moderate Covid-19 who need to take four pills of the drug, twice a day for five days.

Stat reported that molnupiravir — the first pill shown to treat coronavirus successfully — was licensed in the UK for adults aged 18 and above who tested positive for Covid-19 and have at least one risk factor for developing severe illness, like obesity or heart disease.

“I did ask if the advance purchase agreement will require us to put down any upfront payment. They said no. And they said triggering the contract will only take place after the regulatory approval. So, it’s quite attractive as far as the terms are concerned,” Khairy told the health, science and innovation parliamentary special select committee in a meeting on September 28.

He was subsequently asked by Kuala Langat MP Dr Xavier Jayakumar, who was then a member of the parliamentary committee, whether the sale of Covid-19 antivirals will be liberalised for the private market.

“I have to ask [MSD] because, for instance, during the vaccination procurement, some pharmaceutical companies were only selling to governments. So, in this case, I am not sure whether they are selling. But from the sound of it just now, the priority is government,” Khairy said in response to the query.

“There are some vaccine manufacturers like Pfizer who you can buy from as the federal governments and you are prohibited from selling on, contractually. You can give it, but you cannot sell it. So, we cannot sell it to the private sector. 

“But there are companies like Moderna where they only sell to the federal governments and federal governments can sell on to the private sector,” Khairy added, based on transcripts of the meeting published in the special committee’s “Transitioning from Pandemic to Endemic Covid-19 Safely and Sustainably” report that was tabled in Parliament on Monday.

The health minister, on October 7, announced that the government has signed a letter of undertaking with MSD to procure 150,000 treatment courses of the experimental oral antiviral medicine to treat Covid-19.

The decision was made as preparation for Malaysia to move into the endemic phase to live with the Covid-19 virus by adding the choice of new innovative treatments as a “weapon” to fight Covid-19, besides the use of vaccines and other public health measures, Khairy said.

He confirmed that molnupiravir will be provided for free in public health care facilities. 

The drug by Merck and partner Ridgeback Biotherapeutics cost the United States government about US$700 per course for some 1.7 million treatments. Stat reported that Merck plans to use tiered pricing for developing nations.

An interim analysis of MSD’s Phase Three clinical trial on molnupiravir in unvaccinated adults with mild to moderate Covid-19 showed that the medicine reduced the risk of hospitalisation by 50 per cent, the American multinational pharmaceutical company said in an October 1 statement.

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