Comorbidity Burden in Patients with Covid-19 Treated with Molnupiravir in the United States

Individuals with certain medical conditions, e.g., diabetes, heart, and/or lung disease, are at higher risk of severe COVID-19. Molnupiravir, an oral antiviral drug for treatment of mild-to-moderate COVID-19 in certain adults, was granted US FDA emergency use authorization. Retrospective analyses of US patient-level medical and pharmacy claims, and hospital chargemaster data, aggregated by HealthVerity, was conducted. Adults (≥18 years) were indexed to their first outpatient pharmacy fill for molnupiravir between Dec-24-2021 and May-02-2022. Comorbidities were identified using ICD-10 diagnosis, CPT, and/or HCPCS codes during pre-index period (back to Dec-01-2018) and comedications by generic name (from NDCs) ≤90 days before index. Demographic, comorbidity, and comedication characteristics were reported using descriptive statistics. The analyses included 26,191 patients: mean age 58.7 (SD 16.3) years, 59.0% female and 75.9% resided in the South. Presence of ≥1 comorbidity associated with severe COVID-19 was observed in 87.0%: hypertension (52.5%), overweight/obesity (37.4%), mood disorder (30.7%) and cardiovascular disease (18.9%). Diabetes mellitus was observed in 6,944 (26.5%) patients: mean age 62.5 (SD 14.3) years and 54.4% female. Polypharmacy (≥5 comedications) within the last 90 days was also prevalent in both the overall (49.7%) and patients with diabetes (66.1%). Concomitant use of comedications contraindicated with ritonavir-based COVID-19 treatment was noted in 33.7% of all patients and 45.8% of patients with diabetes. Majority of COVID-19 patients treated with molnupiravir in clinical practice were at high risk of severe COVID-19. Future research needs to assess impact of molnupiravir on clinical outcomes in real-world practice, including in patients with comorbid conditions.