Antiviral Molnupiravir Reduces Risk of Hospitalization/Death by ~50 Percent • Hacker News Board

Re: Antiviral Molnupiravir Reduces Risk of Hospitalization/Death by ~50 Percent

#201

Post by PaulDavisThe1st » Fri, Oct 01, 2021, 8:02 PM UTC

admeyer wrote: post #160

Paragraph near the bottom of Reuters article on Molnupiravir states: "Merck has said data shows molnupiravir is not capable of inducing genetic changes in human cells, but men enrolled in its trials had to abstain from heterosexual intercourse or agree to use contraception. Women of child-bearing age in the study could be pregnant and also had to use birth control." Link to said Reuters article: https://www.reuters.c…

Read this comment (directly above this question at the time of reading): https://news.ycombinator.com/item?id=28722155

Re: Antiviral Molnupiravir Reduces Risk of Hospitalization/Death by ~50 Percent

#202

Post by kortex » Fri, Oct 01, 2021, 8:03 PM UTC

nradov wrote: post #42

mmastrac wrote: post #24

Earlier quoted context omitted.

I'm no policy or health care expert, but maybe because front-line and hospital workers are exposed to extremely large viral loads which seem to be related to the severity of the disease, and taking one HCW off the front-lines and adding them to the sick in the ICUs is worse than one less HCW and the same ICU level? This seems like you are trying to start a flamewar about vaccine mandates, BTW.

There's no reliable evidence that healthcare workers wearing proper PPE are exposed to extremely large viral loads. Nor is there evidence that symptom severity depends on initial viral load (beyond some minimum threshold for infection). It's a plausible hypothesis but the human challenge trials necessary to prove or disprove it haven't been done yet.

> Nor is there evidence that symptom severity depends on initial viral load (beyond some minimum threshold for infection).

https://www.nature.com/articles/s41467-020-19057-5

> It's a plausible hypothesis

It's extremely plausible, and been demonstrated before in influenza, poxviruses, and other viruses. The human challenge trials necessary to prove a dose-dependent relationship between fall height and lethality haven't been conducted, either, but we have sufficient evidence from longitudinal and natural experiments to draw firm conclusions.

Re: Antiviral Molnupiravir Reduces Risk of Hospitalization/Death by ~50 Percent

#203

Post by barbazoo » Fri, Oct 01, 2021, 8:03 PM UTC

bshoemaker wrote: post #185

barbazoo wrote: post #167

Earlier quoted context omitted.

Not that I know if. I'm a layman I know pretty much nothing in that field so I'm just having a hard time dismissing the whole Ivermectin thing. Especially now that Merck will make a boatload of money with their new drug. If I was Merck and I had a drug #1 that costs a few cents that might work and I can develop a new drug #2 that will cost $1000, then I'd probably not look into #1 much simply for financial reasons. T…

Sure, but you're suggesting that they are doing that without any evidence. This is classic conspiracy theorist rhetoric, whether that's your intention or not.

Sorry, I don't know how else to question the conspiracy theory itself without mentioning the conspiracy theory. I even called it a conspiracy theory.

Re: Antiviral Molnupiravir Reduces Risk of Hospitalization/Death by ~50 Percent

#204

Post by frostirosti » Fri, Oct 01, 2021, 8:03 PM UTC

LurkingPenguin wrote: post #109

frostirosti wrote: post #65

Earlier quoted context omitted.

> do not want to be vaccinated What's the reason for this? The vaccine has been approved fully by the FDA and hundreds of millions of people have received it. > 2. ... Sure, and people who have had covid and get it again as well. But why risk sick days, lost productivity, severe illness when there's an effective, safe alternative. The capital cost of caring people who get sick with covid is far higher on a per capita…

> do not want to be vaccinated What's the reason for this? The vaccine has been approved fully by the FDA and hundreds of millions of people have received it. It's none of your business why they don't want to be vaccinated. If science demonstrates that COVID survivors have strong immunity, why should they be forced to be vaccinated as well? We do not force people who can show immunity to measles, mumps, and rubella t…

I wonder if the answer to all of this changes if insurance companies decide that covering the cost of laboratory confirmation of covid 19 antibodies or the cost covering the expenses related to hospitalization exceed the cost of vaccination people who may not need it.

If Aetna decided to not cover hospitalization if you are not vaccinated (or I'll give you laboratory confirmed immune), then it would be an entirely different calculus for people.

The argument of "Oh well I'll just find a different insurance provider" doesn't track in the United States either because most people do not have that option. The mandate and the exchange has been almost entirely gutted, so you're left with the option your employer provides.

That's another good point too. The government really doesn't have a lot of say in terms of whether or not you're vaccinated, it's entirely your employer. At the end of the day it's not Aetna/Kaiser/Blue Cross/et al. covering your health care costs, it's your employer. They certainly do not want to cover any unnecessary expense. So requiring employees to be vaccinated is the simplest, scalable, and cost effective solution.

If we're going to point to organizations that have no tolerance for the unvaccinated for diseases other than covid, we need look no futher than the US military: https://www.hhs.gov/immunization/who-and-when/military-membe...

Re: Antiviral Molnupiravir Reduces Risk of Hospitalization/Death by ~50 Percent

#205

Post by PaulDavisThe1st » Fri, Oct 01, 2021, 8:04 PM UTC

shrubble wrote: post #163

smnrchrds wrote: post #39

Earlier quoted context omitted.

Alberta has 173 normal ICU beds. As of this Monday, there were 312 Albertans in ICUs, 265 of whom for COVID [1]. The extra 139 beds were surge capacity, created by shutting down other services, postponing surgeries, and diverting resources to COVID ICU treatments. Even if the number of COVID patients in ICUs halved, we would have 132 people in the ICU with COVID, or 179 patients in total for all causes. It would stil…

Alberta has 4.4 mln or so people. Colorado, with 5.8 mln people, has over 1700 ICU beds. Alberta's been 'running on fumes' re: ICU beds and they got caught out...

Arguably, most of the world's industrial economies have been running on fumes increasingly over the last 30-40 years, as "fat has been trimmed", JIT supply chains have taken over, and "efficiency via merger-then-closure" have been common themes in national economies.

Re: Antiviral Molnupiravir Reduces Risk of Hospitalization/Death by ~50 Percent

#206

Post by barbazoo » Fri, Oct 01, 2021, 8:04 PM UTC

ruaraidh wrote: post #186

barbazoo wrote: post #162

Disclaimer: I'm not promoting Ivermectin here, don't get me wrong. I just want to cover my bases as this announcement is definitely going to be used by people to support their conspiracy theory. Earlier this year Merck the manufacturer of Ivermectin issued this [0] statement saying that Ivermectin isn't useful for preventing/treating Covid-19 and people shouldn't take it. Some people explained that with the fact that…

How could Merck stall those studies? Ivermectin is widely available, you don't need to get Merck's permission to use it in a study.

That's a good point, thanks.

Re: Antiviral Molnupiravir Reduces Risk of Hospitalization/Death by ~50 Percent

#207

Post by mhb » Fri, Oct 01, 2021, 8:04 PM UTC

loeg wrote: post #148

mhb wrote: post #143

Earlier quoted context omitted.

I don't know how the pharma industry decides what to pursue, but it is at least plausible that part of the incentive for what they do depends on being able to price discriminate in sales to other countries. Before suggesting we tear down Chesterton's fence, it seems reasonable that you should have more justification than just that it seems fair to you.

I don't understand your concern -- how does proportional ownership eliminate pharma's ability to price discriminate? I just think the US government should receive some prorated portion of profits from drugs they subsidized development of, which can be reinvested into further development.

These are separate issues. You said that the US is subsidizing drug development for other countries and suggested that you would prefer that we didn't. That affects drug development incentives.

You're also saying that the US government should have some of the profits that the drug companies currently have. Presumably this would affect something that drug companies do. Shouldn't you be concerned that the thing it will affect is them developing new drugs?

Maybe the current situation isn't optimal but there's no reason to think that your suggestions would improve things.

Re: Antiviral Molnupiravir Reduces Risk of Hospitalization/Death by ~50 Percent

#208

Post by PaulDavisThe1st » Fri, Oct 01, 2021, 8:06 PM UTC

logicalmonster wrote: post #153

crooked-v wrote: post #53

Earlier quoted context omitted.

> and is this a goalpost that can ever be achieved? It could absolutely be achieved. Literally the only thing keeping things from going back to more-or-less normal conditions right now is that there are many unvaccinated people getting extremely ill from COVID and filling up ICUs.

Again, what are normal ICU levels? As far as I'm aware, ICU staffing is modified to achieve close to 100% capacity at all times with minimal spare beds, whether pre-Covid or post-Covid. If this is the case, then there's no scenario possible, regardless of what happens with Covid, where hospitals report anything but "few ICU beds are available".

The data collected in the US by the Department of Health has routinely shown ICU availability in my county (Santa Fe, NM). That data has generally indicated that roughly half the available ICU beds are filled, with 1 or 2 patients there due to COVID.

p.s. according to our local newspaper, this data is incorrect.

Re: Antiviral Molnupiravir Reduces Risk of Hospitalization/Death by ~50 Percent

#209

Post by callmeal » Fri, Oct 01, 2021, 8:07 PM UTC

BobbyJo wrote: post #170

avianlyric wrote: post #161

Earlier quoted context omitted.

Even the VCs get a better deal here, they end up with equity. If followed that model, then the taxpayer would own at least 50% of the patents generated (via shares the corporate entity that owned the patents). Under the current model the taxpayer gets nothing, which hardly seems reasonable given the amount of capital they provide.

Don't we already own a portion of what gets created though? If Merck makes a boatload of money off of this, the taxpayers will indeed be taking a cut.

>If Merck makes a boatload of money off of this, the taxpayers will indeed be taking a cut.

Merck's effective tax rate was 15% in 2019 and 20% in 2020[0]

They make boatloads of money by underpaying their taxes [1]:

  In 2004 Merck disclosed that it might owe the U.S. Internal Revenue Service (IRS) some $2 billion after the agency notified the company that it was disallowing deductions Merck had taken since 1993 relating to a partnership set up in 2003 as a vehicle for obtaining financing for the acquisition of Medco.
  
  In 2006 the Wall Street Journal reported that Merck had set up a subsidiary in Bermuda that, in partnership with a British bank, was given title to the patents for the company’s blockbuster cholesterol drugs Zocor and Mevacor, thus saving Merck an estimated $1.5 billion in federal taxes over ten years.
  
  Shortly thereafter, Merck disclosed that it was embroiled in four separate tax disputes in the United States and Canada with total potential liabilities of more than $5 billion. In 2007 the IRS announced that Merck had agreed to pay $2.3 billion to settle its federal tax disputes.

They also make additional boatloads of money overcharging Medicare/Medicaid:

  In 2008 Merck agreed to pay the federal government more than $650 million to settle charges that the company routinely overbilled Medicaid and other government programs and made illegal payments to healthcare professionals to induce them to prescribe its products.
  
  In December 2011 the Massachusetts attorney general announced that Merck would pay $24 million as its part of a $47 million settlement reached with 13 drugmakers to resolve allegations that they overcharged the state’s Medicaid program.
  
  In 2012 the Louisiana attorney general announced that Merck and four other companies would pay a total of $25.2 million to resolve allegations that they overcharged the state’s Medicaid program.

[0] https://www.stock-analysis-on.net/NYSE/Company/Merck-Co-Inc/... [1] https://www.corp-research.org/merck

Re: Antiviral Molnupiravir Reduces Risk of Hospitalization/Death by ~50 Percent

#210

Post by photochemsyn » Fri, Oct 01, 2021, 8:08 PM UTC

rich_sasha wrote: post #117

photochemsyn wrote: post #55

Some interesting points on the nature of our pharmaceutical patent system... (and while the cohort in this study does seem a bit small, the conclusions appear to be fairly valid): > "Molnupiravir was invented at Drug Innovations at Emory (DRIVE), LLC, a not-for-profit biotechnology company wholly owned by Emory University, and is being developed by Merck & Co., Inc. in collaboration with Ridgeback Biotherapeutics." >…

> Clearly, this patent should be assigned to the federal government, not to Merck How about a proportional slice? That would seem fair. IP and products can have fractional ownership.

Ultimately the issue is the licensing of the patent (which is likely retained by Emory or its non-profit affiliate), and under Bayh-Dole universities can exclusively license it.

By introducing non-exclusive licensing, then you have a competitive situation in which the lower-cost manufacturer can provide the drug more cheaply but at the same quality and monopolistic pricing schedules cannot be introduced by the likes of Merck.

The taxpayer benefit is lower cost of drugs invented with taxpayer funds.