essential medicines list
TRANSCRIPT
ESSENTIAL MEDICINES LIST 1
ESSENTIAL MEDICINES LIST
By Sai Ananth, BhavanaAnurag, Saurab Parihar
ESSENTIAL MEDICINES LIST 2
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 ?
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19th WHO Model List of Essential Medicines
*20th WHO Expert Committee
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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
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HISTORY AND EVENTS IN EML
*WHO, “Alliance for Health Policy and Systems Research
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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
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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)
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FACTORS AFFECTING THE IMPLEMENTATION OF EML(NLEM) ON
COUNTRY LEVEL
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National Essential Drugs List
< 5 years (127)
> 5 years (29)
No NEDL (19)
Unknown (16)
Number of countries with NLEM
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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”
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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
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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)
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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
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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
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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
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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
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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
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