Medicines: essential medicines
- Essential medicines are medicines that satisfy the priority health care needs of a population. They are selected with regard to disease prevalence, safety, efficacy, and comparative cost-effectiveness.
- The WHO Model List of Essential Medicines includes over 350 medicines to treat priority conditions.
- The WHO Model List is updated every two years, using a transparent evidence-based process.
- The WHO Model List can be used by countries as a guide for the development of their own national essential medicines list.
- National lists of essential medicines can be used as the basis for procurement and supply of medicines in the public and private sector, schemes that reimburse medicine costs, medicine donations and to guide local medicine production.
Essential medicines are medicines that satisfy the priority health care needs of a population. They are selected with regard to disease prevalence, evidence of efficacy, safety, and comparative cost-effectiveness.
Essential medicines are intended to be available in functioning health systems at all times in adequate amounts, in appropriate dosage forms, with assured quality, and at prices individuals and the community can afford. The availability of medicines in developing countries is compromised by several factors, such as poor medicine supply and distribution systems, insufficient health facilities and staff, low investment in health and the high cost of medicines. Identifying a list of essential medicines for the health care needs of the population can help countries prioritize the purchasing and distribution of medicines, thereby reducing costs to the health system.
What is the WHO Model List of Essential Medicines?
The WHO Model List of Essential Medicines is a list of over 350 medicines. The WHO Model List includes treatment options for priority conditions such as malaria, HIV/AIDS, tuberculosis, reproductive health and also chronic diseases, such as cancer and diabetes, based on evaluation of the best available evidence.
Essential medicines are listed by their International Non-proprietary Name (INN) or generic name, without specifying a manufacturer. The list is updated every two years by the Expert Committee for the Selection and Use of Essential Medicines, using a transparent, evidence-based process. In 2007, the first ever WHO Model List of Essential Medicines for Children was developed and published.
Selection of essential medicines
The medicines included in the WHO Model List of Essential Medicines are selected with regard to disease prevalence, evidence of safety and efficacy, and comparative cost-effectiveness. As costs of medicines change over time, the price of a medicine is not a reason to exclude it from the WHO Model List if it meets the other stated selection criteria. Cost-effectiveness comparisons are made between alternative medicines within the same therapeutic group.
Applications for inclusion, changes or deletions to the Model List are submitted to the secretary of the Expert Committee for the Selection and Use of Essential Medicines. The Expert Committee is responsible for reviewing the evidence provided in an application and deciding whether to include or delete a medicine. The Expert Committee also identifies knowledge gaps and makes recommendations for future research that may be needed about medicines for the treatment of priority health problems. A medicine will be considered for deletion from the WHO Model List if its public health relevance has been questioned and/or there are concerns about its safety and efficacy and comparative cost-effectiveness compared to other medicines for the same condition.
How is the WHO Model List used?
The WHO Model List of Essential Medicines is an evidence-based resource that can be used by countries as a guide to develop their own national essential medicines list. Since the first WHO Model List of Essential Medicines was developed in 1977, many countries have developed their own national list. National lists of essential medicines can be used as the basis for procurement and supply of medicines in the public and private sector, schemes that reimburse medicine costs, medicine donations and to guide local medicine production.
The WHO Model List has been used to develop international lists for special conditions, such as The Interagency Emergency Health Kit (2006) and Essential Medicines for Reproductive Health (2006). Many international organizations, such as the United Nations Children Fund (UNICEF), United Nations High Commission for Refugees (UNHCR) and United Nations Fund for Population Activities (UNFPA), as well as nongovernmental organizations and international non-profit supply agencies, have adopted the essential medicines concept and base their medicine supply system on the WHO Model List.
The WHO Model Formulary is a guide on how to make effective use of the medicines on the WHO Model List of Essential Medicines. It follows the structure and sections used in the WHO Model List and provides a source of independent information on essential medicines for pharmaceutical policy-makers and prescribers worldwide. Also available is a WHO Model Formulary specifically for children.
The WHO Essential Medicines Library is a web-based service that provides access to information concerning individual medicines recorded in the WHO Model List, including disease information and text from the WHO Model Formulary. For each medicine, there are links to clinical evidence about efficacy and safety, WHO or other clinical guidelines, and price information.
Identifying a limited number of essential medicines may lead to a better supply, more rational use, and lower costs. The selection of medicines has a considerable impact on the quality of care and the cost of treatment, it is therefore one of the areas where intervention is most cost-effective. Careful selection of medicines, linked with clinical treatment guidelines and monitoring and evaluation of prescribing can contribute to better health care.
For the past 30 years the WHO Model List has led to a global acceptance of the concept of essential medicines as a powerful means to promote health equity. WHO continues its work in this area by:
- reviewing evidence for the safety, efficacy and comparative cost-effectiveness of medicines;
- developing the WHO Essential Medicines List for Children in 2007;
- revising the Model Essential Medicines Lists and related essential medicine resources regularly;
- providing independent prescriber information in the form of the WHO Model Formulary and the WHO Model Formulary for Children;
- providing technical support to countries for the adoption and implementation of the Essential Medicine List and Formulary; and
- promoting essential medicines strategies in collaboration with other international organizations, including the Interagency Pharmaceutical Coordination group, United Nations Development Programme, International Federation Red Cross and Red Crescent Societies, Médecins sans Frontières, UNICEF, UNHCR, and UNFPA.
For more information contact:
WHO Media centre
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