Weeks before the US #FDA decision on MOV, numerous scientists identified issues with Merck’s statistical analyses, the risks posed to individual patients, and the risks for viral evolution.

Sally Otto and I explained the viral evolution risk here. 6/12 https://virological.org/t/mutagenic-antivirals-the-evolutionary-risk-of-low-doses/768

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Discussion

Unfortunately, MOV was recommended 13-10.

Merck’s case to the FDA repeatedly confused mutation and selection, arguing that all drugs impose selection.

But the problem is mutation: MOV potentiates rare but impactful ‘black swan’ variants. 7/12 https://www.youtube.com/watch?v=fR9FNSJT64M

Concerns about MOV’s risks have sadly been validated.

For example, work by Theo Sanderson and colleagues shows elevated — but sublethal — mutations in viral genomes, consistent with MOV, in regions where it’s used. 8/12 https://www.medrxiv.org/content/10.1101/2023.01.26.23284998v2

Updates on MOV mutations continue to be provided by Ryan Hisner on Twitter.

Further, as he explains, the drug 1) doesn’t work and 2) could be harmful.

The FDA panel argued MOV should be reconsidered after other drugs became available.

That time has come. 9/12

3⃣MEDICARE. Last week, #Merck sued the US government over a new law that will allow Medicare to negotiate certain drug prices — a common practice worldwide.

Failure to negotiate is one reason a vial of insulin costs $300 in the US but $30 in Canada. 10/12 https://www.nytimes.com/2023/06/06/business/merck-medicare-drug-prices.html

One of #Merck’s reasons for suing is likely its cancer drug Keytruda, upon which it relies to maintain yearly profits of US$14.5 billion.

Among other complaints, Merck’s lawyers suggest the company’s ‘free-speech rights’ will be violated. 11/12

In summary, the for-profit health industry urgently needs reform to address

1⃣inordinate profits on good drugs developed from public research

2⃣bad drugs

3⃣price gouging

Such practices have arguably done more than any media influencer to stoke public distrust in science. 12/12