Merck Oral COVID-19 drug, Molnupiravir, Added to Formulary

Published on
January 6, 2022

On December 23, 2021, the U.S. Food and Drug Administration (FDA) issued an emergency use authorization (EUA) for the Merck oral COVID-19 drug, Molnupiravir, for the treatment of mild-to-moderate COVID-19 in adults age 18 years and older. The medication is indicated to treat individuals with a confirmed diagnosis of COVID-19 who are at high risk for progression to severe COVID-19 and for whom alternative treatment options authorized by the FDA are not accessible or clinically appropriate. Molnupiravir requires a prescription and should be initiated after diagnosis of COVID-19 and within 5 days of symptom onset. The medication is not authorized for the prevention of COVID-19.

HHSC added Molnupiravir to the Medicaid and Children’s Health Insurance Program (CHIP) formulary as a payable pharmacy benefit with an effective coverage date of December 27, 2021:

Drug name Dosage Package Size NDC
Molnupiravir EUA 200 mg 40 capsules 00006-5055-06

The dosage for Molnupiravir is 800 mg (four 200mg capsules) taken orally every 12 hours for 5 days. According to the FDA, Molnupiravir is not authorized for individuals under 18 years of age because it may affect bone and cartilage growth. Additionally, the FDA also cautioned Molnupiravir might cause fetal harm in pregnant individuals and is not recommended for use during pregnancy.

There is no ingredient cost associated with the medication because the federal government has purchased treatment courses. The Department of State Health Services (DSHS) will distribute the drug to pharmacies.

DSHS received a limited amount of quantities of Molnupiravir. The initial plan is to allocate those to retail pharmacies, primarily through federal pharmacy partners. DSHS will expand to additional locations as the allocations progress and provide further information about becoming a distribution site to providers and pharmacies. More information for health care providers on Molnupiravir can be found at DSHS Therapeutics, including a map (PDF) of pharmacies where DSHS distributed Molnupiravir for the week of December 27, 2021.