WHO concept of essential
medicines

Dr. Gyanendra Raj Joshi
PharmD, RPh
Rational behind Essential Medicine
List
• Indiscriminate marketing of drugs without
considering the health needs
• Access ...
• The concept of essential medicines
A limited range of carefully selected essential
medicines leads to better health care...
• Essential medicines are intended to be
available within the context of functioning
health systems
– at all times
– in ad...
Advantages
•
•
•
•
•
•

Limited range
High Quality care
Better management of medicines
More cost effective use of resource...
• 1977 First Model list published, ± 200 active
substances
• List is revised every two years by WHO Expert
Committee
• Lat...
• The core list presents a list of minimum medicine
needs for a basic health‐care system, listing the
most efficacious, sa...
Selection of essential medicines
• Two steps:
– Market approval based on efficacy , safety and
quality.
– Evaluation based...
• Factors such as
– Pattern of prevalent disease,
– Treatment facility,
– Training and experience of available personnel,
...
Selection Criteria
•
•
•
•
•

Evidence of efficacy and safety
Relative cost effectiveness
Pharmacokinetics
Availability
De...
The Essential Medicines Target
National list of
essential medicines

Registered medicines

All the drugs
in the world

Lev...
Clinical guidelines and a list of essential
medicines lead to better prevention and
care
List of common diseases and compl...
Practical applications
• Basic and in service training of health care
providers
• Public sector procurement and distributi...
Key policy issues
• Access depending on : rational selection,
affordable prices , sustainable financing and
reliable healt...
Who essential medicine concept
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Who essential medicine concept

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Who essential medicine concept

  1. 1. WHO concept of essential medicines Dr. Gyanendra Raj Joshi PharmD, RPh
  2. 2. Rational behind Essential Medicine List • Indiscriminate marketing of drugs without considering the health needs • Access of people living in rural areas to drugs • For poor and disadvantaged medicines are : – Unavailable – Unaffordable – Unsafe – Improperly used
  3. 3. • The concept of essential medicines A limited range of carefully selected essential medicines leads to better health care, better drug management, and lower costs. • Definition of essential medicines Essential medicines are those that satisfy the priority health care needs of the population.
  4. 4. • Essential medicines are intended to be available within the context of functioning health systems – at all times – in adequate amounts, – in the appropriate dosage forms, – with assured quality and adequate information and – at a price the individual and the community can afford.
  5. 5. Advantages • • • • • • Limited range High Quality care Better management of medicines More cost effective use of resources Real health gains Increased public confidence
  6. 6. • 1977 First Model list published, ± 200 active substances • List is revised every two years by WHO Expert Committee • Latest list in March 2011 (17th edition) containing 350 drugs • 3rd WHO Model List of Essential Medicines for Children
  7. 7. • The core list presents a list of minimum medicine needs for a basic health‐care system, listing the most efficacious, safe and cost‐effective medicines for priority conditions. • The complementary list presents essential medicines for priority diseases, for which specialized diagnostic or monitoring facilities, and/or specialist medical care, and/or specialist training are needed.
  8. 8. Selection of essential medicines • Two steps: – Market approval based on efficacy , safety and quality. – Evaluation based on comparison leading to a list for different levels of care.
  9. 9. • Factors such as – Pattern of prevalent disease, – Treatment facility, – Training and experience of available personnel, – Financial resources – Genetic , demographic and environmental factors.
  10. 10. Selection Criteria • • • • • Evidence of efficacy and safety Relative cost effectiveness Pharmacokinetics Availability Desired dosage form, bioavailability and stability ensured • Single compounds , in some cases fixed dose combinations
  11. 11. The Essential Medicines Target National list of essential medicines Registered medicines All the drugs in the world Levels of use S CHW dispensary Health center Hospital Referral hospital Private sector S Supplementary specialist medicines
  12. 12. Clinical guidelines and a list of essential medicines lead to better prevention and care List of common diseases and complaints Treatment choice Treatment guidelines Essential medicines list / National formulary Training and Supervision Financing and Supply of drugs Prevention and care
  13. 13. Practical applications • Basic and in service training of health care providers • Public sector procurement and distribution • Medicine benefits as part of health insurance • Drug donations and international aid • Monitoring systems on availability and pricing • Public education
  14. 14. Key policy issues • Access depending on : rational selection, affordable prices , sustainable financing and reliable health systems • Selection linked to standard clinical guidelines • Policies for procurement and supply and health insurance • Systematic and transparent procedure

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