essential medicines list

ESSENTIAL MEDICINES LIST 1

ESSENTIAL MEDICINES LIST

By Sai Ananth, BhavanaAnurag, Saurab Parihar


DefinitionEssential medicines are those that satisfy the priority health care needs of the population.

Why EML ?A limited range of carefully selected essential drugs leads to Better health care Better drug management Lower costs.

WHAT IS EML ?


19th WHO Model List of Essential Medicines

*20th WHO Expert Committee


Essential medicines are selected with due regard to Disease prevalence Public health relevance Evidence of clinical efficacy Safety Cost-effectiveness.

CRITERIA OF SELECTION*

*WHO, [Online]. http://www.who.int/topics/essential_medicines/en


HISTORY AND EVENTS IN EML

*WHO, “Alliance for Health Policy and Systems Research


STAKEHOLDERS KEY RESPONSIBILITIES

GOVERNMENT Establish & implement national drug policy. Create awareness among health personnel &

public.PHARMACEUTICAL INDUSTRY

Unbiased product info to govt, prescribers & consumers.

Respond to need of developing countries for low-cost drugs

PRESCRIBERS Rational prescription. Transparent info on healthcare & drug therapy

to patients.ACADEMIC INSTITUTIONS

Continuing education to health care providers Introduce the concept of essential drugs General education on proper health care &

drug therapyCONSUMERS & MEDIA

Share responsibility with govt. & NGO’s for education of consumers.

Support Essential Drug Programme.

DIFFERENT STAKEHOLDERS AFFECTING EML


1977 1979 1983 1985 1988 1990 1992 1995 1997 1998 2000 2002 2003 2005 2007 2009 2011 2013 2015

204235 243

263280

293 300 301 310 317 322341 331 319

337352 358

374

414

Year

No

of D

rugs

WHO EML Updation (1977-2015)


FACTORS AFFECTING THE IMPLEMENTATION OF EML(NLEM) ON

COUNTRY LEVEL


National Essential Drugs List

< 5 years (127)

> 5 years (29)

No NEDL (19)

Unknown (16)

Number of countries with NLEM


AVAILABILITY AND ACCESS OF EML

A survey* in 27 developing countries in 2007 average availability of EML in Public sector- 34.9% Private sector- 63.2%

Why ?Because of low availability of EML in public sector Underfunding or under-budgeting Inaccurate demand forecasting Inefficient public sector procurement & distribution of medicines

*WHO, “Continuity and Change – Implementing the Third Who Medicines Strategy 2008 m-2013”


Introduced & controlled by Ministry of Health & Family Welfare (MOHFW), GOI.

Criteria for inclusion of medicines in NLEM:

Approved by DCGI. Useful in Disease prevailed in India. Be comparatively Cost effective.Aligned with the current treatment guidelines.

Stable under the storage conditions in India.

NATIONAL LIST OF ESSENTIAL MEDICINES IN INDIA


PROCESS ADAPTED FOR NLEM REVISION

Therapeutic area wise group discussion(Group composition: Clinicians, Pharmacologists, Pharmacists,

Scientists and Regulators)

Deliberation on Evidence based criteria for addition and deletion of

medicines from the NLEMConsultation meetings with Experts

National List of Essential Medicines 2003NLEM 2003

(and the revision process continues)


First NLEM 1996 (Revised in 2003) NLEM 2011 (348 Drugs) NLEM 2015 [376 Drugs(106 added & 70 deleted)]Category of Drugs(On basis of health care and disease burden) P→ Primary (206) S → Secondary (115) T → Tertiary (79)(106 additions and 70 deletions)

Medicines deleted from NLEM-2003 (47 Drugs)Acenocoumarol, Aminophylline, Benzylpenicillin, Bretylium Tosylate, Cefuroxime, Clarithromycin….etc.,

Medicines added in NLEM- 2011 (43 Drugs)25% Dextrose, Allopurinol, Amoxicillin+Clavulinic acid, Atorvastatin….etc.,

SALIENT FEATURES OF NLEM


Section: 1 – Anesthesia Section: 2 – Analgesics , Antipyretics, NSAIDS Medicines, Medicines used to treat Gout and Disease Modifying Agents used in Rheumatoid Disorders

Section: 3 – Antiallergics and Medicines used in Anaphylaxis Section: 4 – Antidotes and Other Substances used in Poisonings Section: 5 – Anticonvulsants/ Antiepileptics Section: 6 – Anti-infective Medicines Section: 7 – Antimigraine medicines Section: 8 – Antineoplastic, immunosuppressives and medicines used in palliative care

Section: 9 – Antiparkinsonism medicines Section: 10 – Medicines affecting the blood Section: 11 – Blood products and Plasma substitutes Section: 12 – Cardiovascular medicines

NATIONAL LIST OF ESSENTIAL MEDICINES 2015


Section: 13 – Dermatological medicines (Topical) Section: 14 – Diagnostic agents Section: 15 – Disinfectants and antiseptics Section: 16 – Diuretics Section: 17 – Gastrointestinal medicines Section: 18 – Hormones, other endocrine medicines and contraceptives Section: 19 – Immunologicals Section: 20 – Muscle Relaxants (Peripherally acting) and Cholinesterase Inhibitors

Section: 21 – Ophthalmological Preparations Section: 22 – Oxytocics and Antioxytocics Section: 23 – Peritoneal Dialysis Solution Section: 24 – Psychotherapeutic Medicines Section: 26 – Solutions correcting water, electrolyte and acid-base disturbances

Section: 27 – Vitamins and Minerals

NATIONAL LIST OF ESSENTIAL MEDICINES 2015


Policy making Management Selection Procurement Distribution Quality assurance Financing

PRACTICAL APPLICATIONS OF NLEM

Promoting rational use Training of health

Professionals For providing

medicines information & education

Cost effective therapy


Guides safe and effective treatment of priority disease conditions. Promote the rational use of medicines Optimize the available health resources of a country NLEM-a guiding document for State governments to prepare their list of essential medicines Procurement and supply of medicines in the public sector Reimbursement of cost of medicines by organizations to its employees Reimbursement by insurance companies

PURPOSE OF NLEM

THANK YOU

essential medicines list

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