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Molnupiravir

Phase 3

Coronavirus Disease (COVID-19) | Small molecule | Infectious Disease |Merck & Company, Inc.|Last Updated: Jun 5, 2026

Success Probability
Approval Probability 71%
TA Base Rate26%
Adjusted LOA41%
ML RiskLOW_RISK
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Market & Valuation
rNPV $3.2B
Market Size $9.4B
Revenue Basis $1.6B
Competitors 6
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Trial Design
RandomizedDouble-BlindPLACEBO_CONTROLLEDDMCBiomarker
Total Trials3
Total Enrollment7,258
FDA Designations
No designations recorded
Clinical Trials (3)
NCT IDTitlePhaseStatusEnrollmentVelocityDesignStartCompletionLast UpdatedSitesCountries
NCT06667700A Clinical Study of Molnupiravir to Prevent Severe Illness From Coronavirus Disease 2019 (COVID-19) in People Who Are High Risk (MK-4482-023)PHASE3 RECRUITING 3,082Dec 2, 2024Jan 26, 2031Jun 5, 2026224 United States, Argentina +22
NCT04939428Study of MK-4482 for Prevention of Coronavirus Disease 2019 (COVID-19) in Adults (MK-4482-013)PHASE3 COMPLETED 2,441Aug 11, 2021Nov 16, 2022Sep 26, 2024226 United States, Argentina +21
NCT04575597Efficacy and Safety of Molnupiravir (MK-4482) in Non-Hospitalized Adult Participants With COVID-19 (MK-4482-002)PHASE2 COMPLETED 1,735Oct 19, 2020May 5, 2022Jun 28, 2023173 United States, Argentina +21
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Study Endpoints
Primary Endpoints
Percentage of Participants Who Experienced One or More of Following Through Day 29: All-cause Hospitalization, All-cause Mortality, or Covid-19-related Medically-attended Visit (MAV)
Up to 29 days

Hospitalization is defined as ≥24 hours of acute care in a hospital or similar acute care facility, including emergency rooms or facilities created to address hospitalization needs specifically for COVID-19. Hospitalization and death may be due to any cause. An MAV is defined as any unscheduled, nonroutine healthcare visit where the participant is evaluated by a licensed (according to local/national guidelines) healthcare provider. As prespecified by the protocol, the percentage of participants who experience ONE OR MORE of these 3 events (hospitalization, death, or COVID-19-related MAV) occurring from randomization through Day 29 will be presented.

Percentage of Participants Who Experienced an Adverse Event (AE)
Up to approximately 5 months

An AE is any untoward medical occurrence in a clinical study participant, temporally associated with the use of study intervention, whether or not considered related to the study intervention. The percentage of participants with at least 1 AE will be presented.

Percentage of Participants Who Discontinued Study Intervention Due to AE
Up to approximately 5 days

An AE is any untoward medical occurrence in a clinical study participant, temporally associated with the use of study intervention, whether or not considered related to the study intervention. The percentage of participants who discontinue study intervention due to an AE will be presented.

Percentage of Participants Who Had Undetectable SARS-CoV-2 in Baseline Nasopharyngeal (NP) Swabs and Developed COVID-19 (Laboratory-Confirmed SARS-CoV-2 Infection With Symptoms) Through Day 14
Day 14

Percentage of participants who had undetectable SARS-CoV-2 in baseline NP swabs and developed COVID-19 (laboratory-confirmed SARS-CoV-2 infection with symptoms) through Day 14 were reported.

Percentage of Participants With ≥1 Adverse Event
29 days

An AE is any untoward medical occurrence in a clinical study participant, temporally associated with the use of study intervention, whether or not considered related to the study intervention.

Percentage of Participants Discontinuing From Study Therapy Due to AE
Up to 5 days

An AE is any untoward medical occurrence in a clinical study participant, temporally associated with the use of study intervention, whether or not considered related to the study intervention.

Percentage of Participants Who Were Hospitalized and/or Died Through Day 29 (Primary Pre-specified Analysis)
Up to 29 days

The percentage of participants who were hospitalized and/or died through Day 29 is presented. Hospitalization (all cause) is defined as at least 24 hours of acute care in a hospital or similar acute care facility. Death was due to any cause. Any participants with an unknown survival status at Day 29 were treated as failure. The analysis in Part 2 was based on all participants enrolled by the pre-specified futility/early efficacy analysis and was used for demonstration of superiority to placebo for the primary efficacy outcome measure.

Number of Participants With an Adverse Event (AE)
Up to 318 days

The number of participants with at least 1 AE is presented. An AE is any untoward medical occurrence in a clinical study participant, temporally associated with the use of study intervention, whether or not considered related to the study intervention.

Number of Participants Who Discontinued Study Intervention Due to an AE
Up to 5 days

The number of participants who discontinued study intervention due to an AE is presented. An AE is any untoward medical occurrence in a clinical study participant, temporally associated with the use of study intervention, whether or not considered related to the study intervention.

Secondary Endpoints
Time to Sustained Alleviation (without relapse) of all selected 8 (5 prespecified and 3 determined by baseline prevalence), self-reported COVID-19 signs/symptoms
Up to 29 days
Change from Baseline in Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) RNA Titer
Day 1 (baseline) and up to Day 29
Percentage of Participants with Undetectable SARS-CoV-2 RNA
Up to 29 days
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Study Design & Arms
AllocationRANDOMIZED
MaskingDOUBLE
ModelPARALLEL
PurposeTREATMENT
Treatment Arms
ArmTypeDescription
MolnupiravirEXPERIMENTALParticipants will receive 800 mg molnupiravir orally every 12 hours for 5 days (a total of 10 consecutive doses)
PlaceboPLACEBO_COMPARATORParticipants will receive molnupiravir-matching placebo orally every 12 hours for 5 days (a total of 10 consecutive doses)
Part 1: Molnupiravir 200 mgEXPERIMENTAL200 mg molnupiravir administered orally every 12 hours for 5 days (10 doses total)
Part 1: Molnupiravir 400 mgEXPERIMENTAL400 mg molnupiravir administered orally every 12 hours for 5 days (10 doses total)
Part 1: Molnupiravir 800 mgEXPERIMENTAL800 mg molnupiravir administered orally every 12 hours for 5 days (10 doses total)
Part 1: PlaceboPLACEBO_COMPARATORPlacebo matching molnupiravir administered orally every 12 hours for 5 days (10 doses total)
Part 2: Molnupiravir 800 mgEXPERIMENTAL800 mg Molnupiravir (dose to be selected) administered orally every 12 hours for 5 days (10 doses total)
Part 2: PlaceboPLACEBO_COMPARATORPlacebo matching molnupiravir administered orally every 12 hours for 5 days (10 doses total)
Interventions
NameTypeDescription
MolnupiravirDRUGMolnupiravir administered orally as two 400 mg film-coated tablets every 12 hours for 5 days (a total of 10 consecutive doses)
PlaceboDRUGMolnupiravir-matching placebo administered orally as two film-coated tablets every 12 hours for 5 days (a total of 10 consecutive doses)
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Eligibility Criteria
Age Range18 Years — N/A
SexALL
Healthy VolunteersNo
Study Sites224

Inclusion Criteria The main inclusion criteria include but are not limited to the following: * Is an individual of any sex/gender, ≥18 years of age * Has documentation of SARS-CoV-2 infection with sample collection ≤4 days prior to randomization * Has initial onset of signs/symptoms attributable t...

Countries:United StatesArgentinaBrazilBulgariaColombiaFinlandFranceGeorgiaGermanyItalyJapanMexicoNew ZealandPeruPhilippinesPolandPuerto RicoRomaniaSouth KoreaSpainTaiwanThailandUkraineUnited KingdomDominican RepublicEgyptGuatemalaHungaryKenyaMalaysiaRussiaSouth AfricaTurkey (Türkiye)CanadaChileIsraelSweden
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Recent Changes (Last 90 Days)
LOWJun 5, 2026NCT06667700lastUpdatePostDate: changed
LOWJun 5, 2026NCT06667700lastUpdatePostDate: changed
LOWJun 5, 2026NCT06667700lastUpdatePostDate: changed
LOWJun 5, 2026NCT06667700lastUpdatePostDate: changed
LOWMay 29, 2026NCT06667700lastUpdatePostDate: changed
LOWMay 29, 2026NCT06667700lastUpdatePostDate: changed
LOWMay 29, 2026NCT06667700lastUpdatePostDate: changed
LOWMay 27, 2026NCT06667700lastUpdatePostDate: changed
LOWMay 27, 2026NCT06667700lastUpdatePostDate: changed
LOWMay 26, 2026NCT06667700primaryCompletionDate: changed
LOWMay 24, 2026NCT06667700studyFirstPostDate: changed