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.