Concept of essential medicines lhr 02 24-06

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Concept of essential medicines lhr 02 24-06

  1. 1. CONCEPT OF ESSENTIAL DRUGS Azhar Hussain Associate Professor & Director Hamdard Institute of Pharmaceutical Sciences Hamdard University, Islamabad.
  2. 2. The Access to Medicines Crisis Communicable diseases = leading causes of death in developing countries, accounting for over 25% of all deaths globally 14 million die each year, 97% in developing countries - HIV/AIDS: 3 million per year - Tuberculosis: 2 million per year - Malaria: 1-2 million per year 1/3 of world lacks access to essential quality drugs, diagnostics, vaccines
  3. 3. CONCEPT EMERGENCE • Essential Drugs concept has global relevance & potential to meet global needs • Originated in 1975 • World Health assembly introduced two concepts aimed at Public Health “Essential Drugs” & “National Drug Policy” • Materialized in 1977 when WHO announced its first Model List of Essential Drugs List (EDL) • Declaration of Alma Ata identified “provision of essential drugs” as one of the eight elements of primary health care
  4. 4. CONCEPT EMERGENCE • EDL helped to establish the principle that some medicines were more useful than others and that essential medicines were often inaccessible to many populations
  5. 5. The WHO Model List of Essential Medicines • 1977 - 1st Model List – 208 active substances • 2002 - 12th Model List – 325 active substances – 13th Model List – 14th Model List
  6. 6. National Essential Medicines List < 5 years (127) > 5 years (29) No NEDL (19) Unknown (16) 156 countries with EDLS 1/3 within 2 years 3/4 within 5 years Countries with an official selective list for training, supply, reimbursement or related health objectives. Some countries have selective state/provincial lists instead of or in addition to national lists. 20022002 - at least 156 countries with national / provincial lists for procurement, reimbursement, training, other uses Essential medicines listsEssential medicines lists 19771977 - perhaps a dozen countries with national lists
  7. 7. EDL PAKISTAN • 1st EDL 1988 Drug Formulary • 2nd EDL 1994 • 3rd EDL 1996 477 medicines • 4th EDL 2002 464 medicines • 5th EDL 2005 400 medicines
  8. 8. DEFINING ESSENTAIL MEDICINES • Defining an essential medicine has moved from an experience to an evidence-based process, including criteria such as public-health relevance, efficacy, safety, and cost- effectiveness. • Differences exist between the WHO model EDL and national EDLs since countries face varying challenges relating to costs, drug effectiveness, morbidity patterns, and rationality of prescribing
  9. 9. DEFINING ……. Essential drugs are those that meets priority health care needs, strong evidence of efficacy and safety exists and they represents good value for money, they should also be of assured quality, and sold at a price that individual and community can afford. (WHO)
  10. 10. Pooled procurement Quality assurance STGs Formulary Essential Medicines List Research Monitoring Unbiased Info Rational prescribing
  11. 11. ED list a useful tool for ….. • Policy making • Management • Selection • Procurement • Distribution • Inventory management • Quality assurance • Financing
  12. 12. ED list a useful tool for ….. • Promoting rational use • Training of health Professionals • For providing medicines information and education • Cost effective therapy
  13. 13. FACTORS EFFECTING PRICES Prices of essential medicines in developing countries Generic competition Monopolies Local production Differential pricing TRIPS safeguards High volume Low volume, low demand
  14. 14. Number of drugs from the national essential drug list prescribed, out of total number of drugs prescribed. Geographical Region Public % Private % Federal Area 75.37 49.1 Punjab 81.40 50.11 N.W.F.P 66.24 45.08 Sind 81.07 47.55 Collective 76.02 47.96
  15. 15. Number of drugs from NEDL sold out of total number of drugs sold. Geographical Region Number of Drugs Sold Federal Area 50.66 % Punjab 55.66 % N.W.F.P 48.33 % Sind 55.33 Collective 52.48 %
  16. 16. Average stock-out duration for a basket of drugs Geographical Region Average Stock-out Duration Federal Area 171.3 days Punjab 147.9 days N.W.F.P 278.95 days Sind 197.00 days Collective 198.78 days = 6.62 months
  17. 17. Number of prescribers having direct access to NEDL Geographical Region Prescribers having NEDL Federal Area 10 % Punjab 0 % N.W.F.P 0 % Sind 0 % Collective 2.5 %

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