Essential medicines list

Lindenberg M, Dressman J, Kopp S. Classification of orally administered drugs on the WHO Essential Medicines list according to the BCS. Eur J Pharm Biopharm 2004 58 265-278. 

Essential medicines are those medicines and vaccines that satisfy the most common and important health care needs of the population. An essential medicines list (EML) makes medicine management easier in every respect - procurement, storage, distribution, prescribing and dispensing. The national EML should be determined by national treatment guidelines. Selection of essential medicines for the list is based on clear criteria of efficacy, safety, quality, cost and cost-effectiveness, and the list should be regularly updated. 

Essential medicines lists based on treatments of choice... 

Laing, R., B. Waning, A. Gray, N. Ford, and E. t Hoen. 2003. 25 years of the WHO Essential Medicines Lists Progress and Challenges. Lancet 361 1723-1729. 

Oil-soluble artemether and water-soluble sodium artesunate were developed and approved as new antimalarial drugs by the Chinese authorities in 1987. After 1992, dihydroartemisinin, Coartem (a combination of artemether and benflumetol), and Artekin (a combination of dihydroartemisinin and piperaquine) were also marketed as new antimalarial dmgs. Since then, over 10 million malaria patients on a global scale have been cured after administration of these drugs. As a result, artemether, artesunate, and Coartem were added by the World Health Organization to the ninth, eleventh, and twelfth Essential Medicine List respectively. 

Over the past 25 years, the model list has led to a global acceptance of the concept of essential medicines as a powerful means to promote health equity. By the end of 1999, 156 WHO member states had official essential medicines lists, of which 127 had been updated in the previous five years. 

There may still be oppositions to the use of the essential medicines list. Physicians may see it as questioning their prescription freedom, pharmacists may be worried about the financial implications, while manufacturers may fear a market erosion, and consumers may think that they are being offered second-rate cheap medicines. These concerns must be considered and addressed, and this is why the selection process should be consultative, and why education plays an important part. In fact, an essential medicines policy is nothing but an extension of the selective exercise carried out by the state, on behalf of the rights a community has to useful and safe products, to identify medicines that deserve marketing approval. The principle of convenience is under consideration in an increasing number of countries, especially as the pharmaceutical industry becomes more prolific, more complex, and uses products that are increasingly powerful and, consequently, more hazardous. 

The selection of pharmaceutical products based on a national formulary or on the essential medicines list is recommended. WHO s Model Formulary (15 and Model Essential Medicines List 4) identify the most cost-effective and affordable pharmaceutical products to treat prevailing health problems. They are updated regularly and are made freely available for adaptation by countries. The health systems of many industrialized and developing countries have used the essential medicines concept for decades to use existing resources effectively. Because the use of a national formulary reduces the number of products used, supply management activities and inventorycarrying costs are minimized. 

A committee should be responsible for identifying products to be purchased from the essential medicines list or the national formulary. If such a committee does not exist, an ad hoc committee may be set up for this purpose. 

Medicine Highest oral strength according to WHO Essential Medicines List" Solubility Permeability BCS class Dissolution test (for biowaiver)" Potential risks Indication(s) according to WHO Essential Medicines List" Comments and special dosage form indications"... 

The Williams list of compounds [33] could also be scrutinized in the same manner as the WHO essential medicines list. It is however, an extensive set of substances and represents a wide range of therapeutic classes. Once again better and more recent sets could be devised for this study and the Williams set was selected as a useful representative set and for the large number of compounds it contained. As mentioned above this aspect of the study is being addressed in future work in these laboratories using the compounds listed in the AHFS Drug Handbook [51]. 

In order to meet the pharmaco-therapeutic needs of PFPB users, the Ministry of Health established a list of medicines based on the National Essential Medicines List, which was defined using epidemiological criteria, taking into account the principal diseases that affect the Brazilian population and the treatments that have the greatest impact... 

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