In December 2021, the FDA issued an emergency use authorization for the antiviral drug Lagevrio (molnupiravir) to reduce the severity of symptoms and hospitalization in adults with mild to moderate cases of COVID-19 for whom other FDA-approved treatment options (Paxlovid or remdesivir) are not accessible or clinically appropriate. We studied 1,666,083 cases of COVID-19 in adults between December 23, 2021, and July 31, 2022. Of these cases, Lagevrio was prescribed nearly nine times less frequently than Paxlovid (21,615 Lagevrio treatments vs. 191,848 Paxlovid treatments). We also found that the population treated with Lagevrio was older on average compared to the population prescribed Paxlovid (Figure 1).
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To identify how Lagevrio has affected hospital admissions and deaths in COVID-19 patients, we looked at cases involving patients who were 18 and older and had at least one comorbidity and whether they were hospitalized two or more days after their initial COVID-19 diagnosis. When comparing the population that received Lagevrio to the patients who received neither Lagevrio nor Paxlovid, we found decreases in hospital admissions and deaths for the Lagevrio population within each age group (Figure 2). The largest differences were found in the 65+ age group where we found a 38.12% reduced admission rate and a 51.96% reduced death rate compared to those who took neither Lagevrio nor Paxlovid. Patients who were hospitalized less than two days after their COVID-19 diagnosis were excluded because they may not have had time to initiate treatment to prevent hospitalization.
This study did not evaluate or adjust for vaccination status, comorbidity type, or socioeconomic status, which might also affect a patient’s likelihood of hospitalization or death from COVID-19.2,3
Paxlovid remains the most widely used and efficacious antiviral drug when treating COVID-19.4,5 However, this analysis suggests Lagevrio may be a good alternative to reduce the risk of COVID-19 hospitalization or death for patients 65 and older who have comorbidities but are not eligible for Paxlovid.
