Are Pfizer Paxlovid and Merck Molnupiravir cost-effective?

Event: On April 17, 2022, the Shenzhen No.

Source: Minutes of COVID-19 cases in Shenzhen No.

The results of a retrospective cohort study of Pfizer’s Paxlovid (Nimatvir/Ritonavir) in the treatment of novel coronavirus Omicron in Shenzhen Third Hospital showed:

1.

2.

3.

4.

Source: Minutes of COVID-19 cases in Shenzhen No.

The results of a randomized controlled study of Merck's Molnupiravir (Monaprevir) in the treatment of new coronavirus Omicron from Shenzhen Third Hospital showed:

1.

2.

3.

4.

Discussion 1: Does Paxlovid or Molnupiravir have high efficacy and economic value for the currently popular and fast-spreading Omicron patients with mild disease?

The two small samples of Shenzhen Third Hospital were used to treat mild patients (or including those with high risk factors) of the new crown of Omicron.

From the perspective of pharmacoeconomics, on the one hand, the price of Pfizer Paxlovid in China is 2300/box.

Source: Public data, compiled by Zhongkang Capital Research Center

The pivotal Phase III clinical trial approved by Pfizer Paxlovid achieved very significant effects (P<0.

Source: Public data, compiled by Zhongkang Capital Research Center

Merck's Phase III clinical trial of Molnupiravir, the primary endpoint of the trial (severe disease), does not seem to be better than Pfizer's Paxlovid, with a difference of only 3% between the control and drug groups

Discussion 2: For the currently popular and fast-spreading Omicron patients with mild disease, is there a considerable curative effect and economic value in the simple use of traditional Chinese medicine?

The Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine recently released the "Shanghai Expert Consensus on the Diagnosis and Treatment of Novel Coronavirus Infection with Traditional Chinese Medicine (Spring Edition 2022)" in cooperation with the Shanghai New Coronary Pneumonia TCM Treatment Expert Group.

Judging from the experience in Chinese medicine treatment of new coronary pneumonia Omicron variant strains obtained in many places across the country, the fever reduction rate of patients who only use traditional Chinese medicine is more than 70% within 1 day after taking Chinese medicine, and the fever reduction rate within 3 days is as high as 95%.
More than 65% of the patients were hospitalized for less than 7 days, the average nucleic acid conversion time was 4 to 6 days, and the severe conversion rate was less than 0.
01%
.
According to previous public data from the state, the treatment cost of a course of traditional Chinese medicine is about more than 100 yuan.
Therefore, simply using traditional Chinese medicine to treat the currently popular and fast-spreading Omicron patients with mild disease may have considerable curative effect and economic value
.

Epilogue

From the actual situation, for the fast-spreading Omicron strain, the population vaccine protection rate is relatively high for mild cases, compared with traditional Chinese medicine treatment, Pfizer Paxlovid and Merck Molnupiravir have not yet more detailed data to confirm the higher efficacy and Economic value, which also requires more clinical data to prove, and we also expect better data unblinding for the next domestic drugs
.