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Use of molnupiravir: a Danish nationwide drug utilization study
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  • Louise Ladebo,
  • Lotte Rasmussen,
  • Peter Bjødstrup Jensen,
  • Mette Lindahl,
  • Anne Øvrehus,
  • Jesper Hallas,
  • Mette Reilev
Louise Ladebo
Syddansk Universitet Klinisk Farmakologi Farmaci og Miljomedicin
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Lotte Rasmussen
Syddansk Universitet Klinisk Farmakologi Farmaci og Miljomedicin
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Peter Bjødstrup Jensen
Syddansk Universitet Klinisk Farmakologi Farmaci og Miljomedicin
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Mette Lindahl
Fredericia Kommune
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Anne Øvrehus
Odense Universitetshospital
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Jesper Hallas
Syddansk Universitet Klinisk Farmakologi Farmaci og Miljomedicin
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Mette Reilev
Syddansk Universitet Klinisk Farmakologi Farmaci og Miljomedicin

Corresponding Author:mreilev@health.sdu.dk

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Abstract

Purpose To describe utilization patterns, characteristics of users and prescriber responsibility of the new oral antiviral medication, molnupiravir, indicated for mild-to-moderate COVID-19. Methods Using nationwide registries, we identified all Danish adults who filled a prescription for molnupiravir from December 16 th, 2021, to August 31 st, 2022. We described weekly incidence rates and patient characteristics over time, prescriber responsibility as well as time between molnupiravir initiation and a positive SARs-CoV-2 test. Patient characteristics were compared to an untreated SARS-CoV-2 positive cohort. Results By August 31 st, 2022, 5,847 individuals had filled a prescription for molnupiravir. The incidence rate gradually increased to 2,000 weekly prescriptions per 100,000 RT-PCR SARS-CoV-2 positives. Users of molnupiravir were most often men (55% vs. 45% women). The majority (81%) had a positive RT-PCR SARS-CoV-2 test and few (2.9%) redeemed molnupiravir outside the recommended window of 5 days from the positive test result. Compared to an untreated SARS-CoV-2 positive cohort, users of molnupiravir had a median age of 74 years vs. 44 years, a higher proportion resided in a nursing home (12% vs. 1.1%) and had a higher number of comorbidities (median of 3 vs. 0); most commonly hypertension (38%), chronic lung disease (35%), diabetes (20%) and mood disorders (20%). General practitioners were the primary prescribers of molnupiravir (91%). Conclusions Molnupiravir was mainly prescribed by general practitioners to RT-PCR SARS-CoV-2 positive individuals who had a potentially increased risk of severe COVID-19. Though some off-label prescribing occurred, our study indicates a high level of adherence to contemporary guidelines.
27 Feb 2023Submitted to Pharmacoepidemiology and Drug Safety
27 Feb 2023Submission Checks Completed
27 Feb 2023Review(s) Completed, Editorial Evaluation Pending
27 Feb 2023Assigned to Editor
24 Mar 2023Reviewer(s) Assigned
23 May 2023Editorial Decision: Revise Major
17 Jul 20231st Revision Received
17 Jul 2023Submission Checks Completed
17 Jul 2023Assigned to Editor
17 Jul 2023Review(s) Completed, Editorial Evaluation Pending
12 Sep 2023Editorial Decision: Accept