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Merck and Ridgeback Announce That 3.1 Million Courses of Molnupiravir, an Investigational Oral Antiviral COVID-19 Medicine, Merck and Ridgeback Announce That 3.1 Million Courses of Molnupiravir, an Investigational Oral Antiviral COVID-19 Medicine, Have Been Supplied to the U.S. Government for Use in the United States Merck Has Completed Manufacturing of 10 Million Courses of Therapy and Remains on Track to Produce at Least 20 Million Courses in 2022 to Provide Widespread Access to Molnupiravir Globally

Business Wire

KENILWORTH, N.J. & MIAMI — February 8, 2022

Merck (NYSE: MRK), known as MSD outside the United States and Canada, and Ridgeback Biotherapeutics today announced that a total of approximately 3.1 million courses of molnupiravir, an investigational oral antiviral COVID-19 medicine, have been provided to the U.S. government for allocation across the country. The U.S. Department of Health and Human Services (HHS) has created a public website to help providers identify locations that have received shipments of government procured COVID-19 therapeutics available under Emergency Use Authorization. In 2021, Merck entered a procurement agreement with the U.S. government under which the company agreed to supply approximately 3.1 million courses of molnupiravir to the U.S. government upon Emergency Use Authorization or approval from the U.S. Food and Drug Administration.

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“As we start 2022, more than 2,000 COVID-19 deaths are being reported in the

U.S. daily, which underscores the need for medicines including molnupiravir

that can be taken at home. In line with our commitment to accelerating access

to molnupiravir in the U.S., we have now supplied more than 3 million courses

to the U.S. government within approximately 7 weeks of receiving Emergency Use

Authorization from the U.S. Food and Drug Administration,” said Robert M.

Davis, chief executive officer and president, Merck. “I am grateful to our

colleagues who have worked tirelessly over the past year to accomplish this

goal and to the health care providers who remain on the front lines of caring

for patients with COVID-19.”

“We believe that molnupiravir will be a critical addition in helping curb the

impact of COVID-19 on patients and health care systems in the U.S.,

particularly with the medicine’s antiviral activity against many variants of

concern. We will continue to work with urgency to bring this important

medicine to appropriate patients as quickly as possible,” said Wendy Holman,

chief executive officer, Ridgeback Biotherapeutics.

In addition to the U.S. agreement, Merck has entered into advance purchase and

supply agreements for molnupiravir in more than 30 markets worldwide,

including Australia, Canada, Korea, Japan, Thailand, Ukraine and United

Kingdom, pending regulatory authorizations, and is currently in discussions

with additional governments. To date, Merck has shipped molnupiravir to more

than 25 countries; in countries where it is approved or authorized, patients

have begun to receive the medicine.

About Merck’s Global Efforts to Accelerate Access to Molnupiravir Following Regulatory Authorizations or Approvals

Global access has been a priority for Merck and Ridgeback since the inception

of their molnupiravir collaboration. The companies are committed to providing

timely access to molnupiravir globally through our comprehensive supply and

access approach, which includes investing at risk to produce millions of

courses of therapy; tiered pricing based on the ability of governments to

finance health care; entering into supply agreements with governments;

allocating up to 3 million courses of therapy for distribution through UNICEF

and the ACT Accelerator Therapeutics Partnership; and granting voluntary

licenses to generic manufacturers and to the Medicines Patent Pool to make

generic molnupiravir available in more than 100 low- and middle-income

countries following local regulatory authorizations or approvals.

Supply: In anticipation of the results from MOVe-OUT and the potential for

regulatory authorization or approval, Merck produced molnupiravir at risk,

manufacturing 10 million courses of treatment by the end of 2021, with at

least 20 million courses expected to be produced in 2022. To date, Merck has

shipped molnupiravir to over 25 markets, including approximately 3.1 million

patient courses supplied to the U.S. government; in countries where it is

approved or authorized, patients have begun to receive the medicine. To supplement the supply from licensed generic manufacturers, Merck has entered an agreement with UNICEF to allocate up to 3 million courses of therapy to low- and middle-income countries through the first half of 2022.

Supply agreements: Merck entered into a procurement agreement with the U.S. government under which the company has supplied approximately 3.1 million courses of molnupiravir to the U.S. government, upon Emergency Use Authorization or approval from the U.S. Food and Drug Administration. The procurement of molnupiravir was supported in whole or in part with federal funds from the Department of Health and Human Services; Office of the Assistant Secretary for Preparedness and Response; Biomedical Advanced Research and Development Authority, in collaboration with the DOD Joint Program Executive Office for Chemical, Biological, Radiological and Nuclear Defense (JPEO-CBRND) under contract number W911QY21C0031.

The U.S. Department of Health and Human Services (HHS) has created a public

website to help providers locate dispensing sites that have received shipments

of government-procured COVID-19 therapeutics available under Emergency Use

Authorization. Merck has also entered into advance purchase and supply

agreements for molnupiravir with governments for over 30 markets worldwide,

including Australia, Canada, Korea, Japan, Thailand, Ukraine and United

Kingdom, pending regulatory authorizations, and is currently in discussions

with additional governments. Merck is implementing a tiered pricing approach

based on World Bank country income criteria to reflect countries’ relative

ability to finance their health response to the pandemic.

Voluntary licenses: As part of its commitment to widespread global access, Merck previously announced that it has entered into a licensing agreement with the Medicines Patent Pool to increase broad access for molnupiravir in low- and middle-income countries. Additionally, Merck previously announced that the company has entered into non-exclusive voluntary licensing agreements for molnupiravir with established generic manufacturers to accelerate availability of molnupiravir in more than 100 low- and middle-income countries following approvals or emergency authorization by local regulatory agencies.

Merck continues to discuss additional measures and collaborations to accelerate broad, global access to molnupiravir.

Authorized Use of Molnupiravir in the U.S.

The U.S. Food and Drug Administration (FDA) has issued an EUA for the emergency use of the unapproved molnupiravir, a nucleoside analogue that inhibits SARS-CoV-2 replication by viral mutagenesis, for the treatment of mild to moderate coronavirus disease 2019 (COVID-19) in adults with positive results of direct SARS-CoV-2 viral testing, and who are at high risk for progression to severe COVID-19, including hospitalization or death, and for whom alternative COVID-19 treatment options authorized by FDA are not accessible or clinically appropriate. Molnupiravir is not FDA-approved for any use including for use for the treatment of COVID-19. Prior to initiating treatment with molnupiravir, carefully consider the known and potential risks and benefits.

Molnupiravir is authorized only for the duration of the declaration that circumstances exist justifying the authorization of the emergency use of molnupiravir under section 564(b)(1) of the Federal, Food, Drug, and Cosmetic Act, 21 U.S.C. § 360bbb-3(b)(1), unless the authorization is terminated or revoked sooner.

Molnupiravir is not authorized for use in patients less than 18 years of age or who are hospitalized due to COVID-19. Benefit of treatment with molnupiravir has not been observed in subjects when treatment was initiated after hospitalization due to COVID-19. Molnupiravir is not authorized for use for longer than five consecutive days. Molnupiravir is not authorized for pre-exposure or post-exposure prophylaxis for prevention of COVID-19.Molnupiravir may only be prescribed for an individual patient by physicians, advanced practice registered nurses, and physician assistants that are licensed or authorized under state law to prescribe drugs in the therapeutic class to which molnupiravir belongs (i.e., anti-infectives).

Selected Safety Information for Molnupiravir

Contraindications

No contraindications have been identified based on the limited available data on the emergency use of molnupiravir authorized under this EUA.

Warnings and Precautions

There are limited clinical data available for molnupiravir. Serious and unexpected adverse events may occur that have not been previously reported with molnupiravir use.

Molnupiravir is not recommended for use during pregnancy. Based on findingsfrom animal reproduction studies, molnupiravir may cause fetal harm when administered to pregnant individuals. There are no available human data on the use of molnupiravir in pregnant individuals to evaluate the risk of major birth defects, miscarriage or adverse maternal or fetal outcomes.

Molnupiravir is authorized to be prescribed to a pregnant individual only after the healthcare provider has determined that the benefits would outweigh the risks for that individual patient. If the decision is made to use molnupiravir during pregnancy, the prescribing healthcare provider must document that the known and potential benefits and the potential risks of using molnupiravir during pregnancy were communicated to the pregnant individual.

There is a pregnancy surveillance program that monitors pregnancy outcomes in individuals exposed to molnupiravir during pregnancy. The prescribing healthcare provider must document that a pregnant individual was made aware of

Merck’s pregnancy surveillance program at 1-877-888-4231 or

pregnancyreporting.msd.com.

If the pregnant individual agrees to participate

in the pregnancy surveillance program and allows the prescribing healthcare provider to disclose patient specific information to Merck, the prescribing healthcare provider must provide the patient’s name and contact information to Merck. Pregnant individuals exposed to molnupiravir can also report the exposure by contacting Merck at 1-877-888-4231 or pregnancyreporting.msd.com.

Advise individuals of childbearing potential of the potential risk to a fetus and to use an effective method of contraception correctly and consistently during treatment with molnupiravir and for 4 days after the final dose.

Prior to initiating treatment with molnupiravir, assess whether an individual of childbearing potential is pregnant or not, if clinically indicated.

Molnupiravir is not authorized for use in patients less than 18 years of age because it may affect bone and cartilage growth. The safety and efficacy of molnupiravir have not been established in pediatric patients.

Adverse Reactions

The most common adverse reactions occurring in ≥1% of subjects in the

molnupiravir treatment group in the Phase 3 double-blind MOVe-OUT study were:

  • diarrhea (2% versus placebo at 2%), nausea (1% versus placebo at 1%), and
  • dizziness (1% versus placebo at 1%) all of which were Grade 1 (mild) or Grade
  • 2 (moderate).
  • Serious adverse events occurred in 7% of subjects receiving molnupiravir and
  • 10% receiving placebo; most serious adverse events were COVID-19 related.
  • Adverse events leading to death occurred in 2 (<1%) of the subjects receiving
  • molnupiravir and 12 (2%) of subjects receiving placebo.

Drug Interactions

No drug interactions have been identified based on the limited available data on the emergency use of molnupiravir. No clinical drug-drug interaction trials of molnupiravir with concomitant medications, including other treatments for mild to moderate COVID-19, have been conducted.

Pregnancy/Breastfeeding

There are no data on the presence of molnupiravir or its metabolites in human

milk. It is unknown whether molnupiravir has an effect on the breastfed infant

or effects on milk production. Based on the potential for adverse reactions in

the infant from molnupiravir, breastfeeding is not recommended during

treatment with molnupiravir and for 4 days after the final dose. A lactating

individual may consider interrupting breastfeeding and may consider pumping

and discarding breast milk during treatment and for 4 days after the last dose

of molnupiravir.

Males of Reproductive Potential

Nonclinical studies to fully assess the potential for molnupiravir to affect

offspring of treated males have not been completed. Advise sexually active

individuals with partners of childbearing potential to use a reliable method

of contraception correctly and consistently during treatment and for at least

3 months after last dose of molnupiravir. The risk beyond three months after

the last dose of molnupiravir is unknown.

Required Reporting for Serious Adverse Events and Medication Errors

The prescribing healthcare provider and/or the provider’s designee are/is

responsible for mandatory reporting of all serious adverse events and

medication errors potentially related to molnupiravir within 7 calendar days

from the healthcare provider’s awareness of the event.

Submit adverse event and medication error reports, using FDA Form 3500, to FDA

MedWatch using one of the following methods:

* Complete and submit the report online: http://www.fda.gov/medwatch/report.htm

* Complete and submit a postage-paid FDA Form 3500

(https://www.fda.gov/media/76299/download) and return by:

* Mail to MedWatch, 5600 Fishers Lane, Rockville, MD 20852-9787, or

* Fax to 1-800-FDA-0178

* Call 1-800-FDA-1088 to request a reporting form

In addition, please provide a copy of all FDA MedWatch forms to:

Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Kenilworth, NJ

USA by:

Fax: 215-616-5677

E-mail: dpoc.usa@merck.com

About Molnupiravir

Molnupiravir (MK-4482) is an investigational, orally administered nucleoside

analog that inhibits the replication of SARS-CoV-2, the causative agent of

COVID-19.

Merck and Ridgeback’s “orange COVID-19 pill” is a Swedish Orange opaque

capsule with the Merck corporate logo and “82” printed in white ink, available

in certain markets outside of the U.S. as LAGEVRIO^®.

Results from the Phase 3 MOVe-OUT study demonstrated the efficacy benefit of

molnupiravir treatment was generally consistent across patients infected with

SARS-CoV-2 variants of concern, Delta, Gamma and Mu. Preclinical data has

shown that molnupiravir has antiviral activity against the newly identified

variant, Omicron (B1.1.529). Molnupiravir has yet to be evaluated against

Omicron in clinical studies.

Molnupiravir was invented at Emory University. Drug Innovation Ventures at

Emory (DRIVE), LLC, which was formed by Emory to develop early-stage drug

candidates for viral diseases of global concern, advanced molnupiravir through

IND submission. Emory/DRIVE received some research funding from the U.S.

Department of Defense and the U.S. National Institutes of Health. Molnupiravir

is being developed by Merck in collaboration with Ridgeback Biotherapeutics.

Ridgeback received an upfront payment from Merck and also is eligible to

receive contingent payments dependent upon the achievement of certain

developmental and regulatory approval milestones. Any profits from the

collaboration will be split between the partners equally. Since licensed by

Ridgeback, all funds used for the development of molnupiravir have been

provided by Merck and Ridgeback.

Molnupiravir was evaluated in MOVe-OUT, a global Phase 3, randomized,

placebo-controlled, double-blind, multi-site study of non-hospitalized adult

patients with symptomatic, laboratory-confirmed mild to moderate COVID-19 and

at least one risk factor associated with poor disease outcomes. The Phase 3

portion of the MOVe-OUT trial was conducted globally in more than 170 sites in

locations including Argentina, Brazil, Canada, Chile, Colombia, Egypt, France,

Germany, Guatemala, Israel, Italy, Mexico, Philippines, Poland, Russia, South

Africa, Spain, Sweden, Taiwan, Ukraine, the United Kingdom and the United

States. For further information about the MOVe-OUT trial, please visit

clinicaltrials.gov. Molnupiravir is also being evaluated for post-exposure

prophylaxis in MOVe-AHEAD, a global, multicenter, randomized, double-blind,

placebo-controlled Phase 3 study evaluating the efficacy and safety of

molnupiravir in preventing the spread of COVID-19 within households. For more

information, please visit http://merckcovidresearch.com.

Please visit the Merck media library for molnupiravir images and b-roll.

About Ridgeback Biotherapeutics

Headquartered in Miami, Florida, Ridgeback Biotherapeutics LP is a

biotechnology company focused on emerging infectious diseases. Ridgeback

markets Ebanga™  for the treatment of Ebola and has a late-stage development

pipeline which includes molnupiravir for the treatment of COVID-19. The team

at Ridgeback is dedicated to developing life-saving and life-changing

solutions for patients and diseases that need champions as well as providing

global access to these medicines. In line with Ridgeback’s mission for

equitable global access, all Ridgeback services and treatment for Ebola

patients in Africa are delivered free of charge.

About Merck

For over 130 years, Merck, known as MSD outside the United States and Canada,

has been inventing for life, bringing forward medicines and vaccines for many

of the world’s most challenging diseases in pursuit of our mission to save and

improve lives. We demonstrate our commitment to patients and population health

by increasing access to health care through far-reaching policies, programs

and partnerships. Today, Merck continues to be at the forefront of research to

prevent and treat diseases that threaten people and animals – including

cancer, infectious diseases such as HIV and Ebola, and emerging animal

diseases – as we aspire to be the premier research-intensive biopharmaceutical

company in the world. For more information, visit http://www.merck.com and connect

with us on Twitter, Facebook, Instagram, YouTube and LinkedIn.

Forward-Looking Statement of Merck & Co., Inc., Kenilworth, N.J., USA.

This news release of Merck & Co., Inc., Kenilworth, N.J., USA (the “company”)

includes “forward-looking statements” within the meaning of the safe harbor

provisions of the U.S. Private Securities Litigation Reform Act of 1995. These

statements are based upon the current beliefs and expectations of the

company’s management and are subject to significant risks and uncertainties.

There can be no guarantees with respect to pipeline candidates that the

candidates will receive the necessary regulatory approvals or that they will

prove to be commercially successful. If underlying assumptions prove

inaccurate or risks or uncertainties materialize, actual results may differ

materially from those set forth in the forward-looking statements.

Risks and uncertainties include but are not limited to, general industry

conditions and competition; general economic factors, including interest rate

and currency exchange rate fluctuations; the impact of the global outbreak of

novel coronavirus disease (COVID-19); the impact of pharmaceutical industry

regulation and health care legislation in the United States and

internationally; global trends toward health care cost containment;

technological advances, new products and patents attained by competitors;

challenges inherent in new product development, including obtaining regulatory

approval; the company’s ability to accurately predict future market

conditions; manufacturing difficulties or delays; financial instability of

international economies and sovereign risk; dependence on the effectiveness of

the company’s patents and other protections for innovative products; and the

exposure to litigation, including patent litigation, and/or regulatory

actions.

The company undertakes no obligation to publicly update any forward-looking

statement, whether as a result of new information, future events or otherwise.

Additional factors that could cause results to differ materially from those

described in the forward-looking statements can be found in the company’s 2020

Annual Report on Form 10-K and the company’s other filings with the Securities

and Exchange Commission (SEC) available at the SEC’s Internet site

(www.sec.gov).

Please see the Molnupiravir FDA Letter of Authorization at

https://www.merck.com/eua/Merck-EUA-letter.pdf, Fact Sheet for Healthcare

Providers, including Mandatory Requirements for Administration of Molnupiravir

under Emergency Use Authorization, at

https://www.merck.com/eua/molnupiravir-hcp-fact-sheet.pdf and Fact Sheet for

Patients and Caregivers at

https://www.merck.com/eua/molnupiravir-patient-fact-sheet-english.pdf.

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Investor:

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Damini Chokshi

(908) 740-1807