NLEM, or the National List of Essential Medicines, is a crucial tool in prioritizing healthcare needs and guiding decision-making in the pharmaceutical sector. It includes a list of vital drugs deemed necessary for the population's healthcare, focusing on efficacy, safety, and cost-effectiveness. The National List of Essential Medicines (NLEM) outlines the essential medications that are vital for addressing the priority health needs of the population. It plays a crucial role in ensuring the availability and accessibility of essential medicines in primary health care services.

1. Dr Asif Khan
Dr Asif Khan
Introduction to NLEM
NLEM, or the National List of Essential Medicines, is a crucial tool in
prioritizing healthcare needs and guiding decision-making in the
pharmaceutical sector. It includes a list of vital drugs deemed necessary
for the population's healthcare, focusing on efficacy, safety, and cost-
effectiveness.
The National List of Essential Medicines (NLEM) outlines the essential
medications that are vital for addressing the priority health needs of the
population. It plays a crucial role in ensuring the availability and
accessibility of essential medicines in primary health care services.
Dr Asif Khan
Professor
Kanachur Institute of Medical Sciences
Mangalore

2. Dr Asif Khan
Dr Asif Khan
Rationale behind the NLEM
• Equitable Access: Ensures availability of
essential medicines to all, regardless of income
or location
• Cost-effective Treatment: Focuses on cost-
effective medications to optimize healthcare
resources
• Public Health Priority: Addresses prevalent
health issues and prioritizes essential
medications

3. Dr Asif Khan
Dr Asif Khan
Essential Medicines are intended
to be available
• at all times
• In adequate amounts
• In appropriate dosage forms
• Of assured quality & adequate
information
• at a price the individual & community
can afford.

4. Dr Asif Khan
Dr Asif Khan
Categories of drugs included in the
NLEM
• 1 Medicines used in Anaesthesia
• 2 Analgesics, Antipyretics, Non-steroidal Anti-
inflammatory
• Drugs (NSAIDs), Medicines used to treat Gout and
Disease Modifying Agents
• used in Rheumatoid Disorders
• 3 Antiallergics and Medicines used in Anaphylaxis
• 4 Antidotes and Other Substances used in
Management of
• Poisonings/Envenomation
• 5 Medicines used in Neurological Disorders
• 6 Anti-infective Medicines
• 7 Anti-cancer agents including
Immunosuppressives and Medicines used in
• Palliative Care
• 8 Medicines affecting Blood
• 9 Blood products and Plasma substitutes
• 10 Cardiovascular Medicines
• 11 Dermatological Medicines (Topical)
• 12 Diagnostic agents
• 13 Dialysis components (Haemodialysis and Peritoneal Dialysis)
• 14 Antiseptics and Disinfectants
• 15 Diuretics
• 16 Ear, Nose and Throat Medicines
• 17 Gastrointestinal Medicines
• 18 Hormones, other Endocrine Medicines and Contraceptives
• 19 Immunologicals
• 20 Medicines for Neonatal Care
• 21 Ophthalmological Medicines
• 22 Oxytocics and Antioxytocics
• 23 Medicines used in treatment of Psychiatric Disorders
• 24 Medicines acting on the Respiratory tract
• 25 Solutions correcting Water, Electrolyte disturbances and Acid-
base
• disturbances
• 26 Vitamins and Minerals
• 27 Medicines for COVID 19 management

5. Dr Asif Khan
Dr Asif Khan
Essential Medicines for
Maternal and Child Health
Essential medicines for maternal and child health
encompass a wide range of pharmaceuticals,
including those vital for prenatal care, management of
labor, postpartum care, neonatal health, and pediatric
illnesses.
These medicines play a crucial role in ensuring the
well-being and health of mothers and children across
various healthcare settings.

6. Dr Asif Khan
Dr Asif Khan
Essential Medicines for
Reproductive Health
• Emergency Contraceptives: Medications to
prevent pregnancy after unprotected intercourse
or contraceptive failure.
• Medications for Menstrual Disorders: Drugs
to address irregular or excessive bleeding, and
menstrual pain.
• Infertility Treatment Drugs: Essential
medications to treat reproductive health
disorders causing infertility.

7. Dr Asif Khan
Dr Asif Khan
Essential Medicines for Immunization
Vaccines
Vaccines are
crucial for
preventing
infectious
diseases through
immunization.
Pediatric Doses
Special
formulations and
doses of essential
vaccines for
children's
immunization.
Vaccine Storage
Proper storage
and handling of
vaccines to
maintain their
efficacy.
Injection Safety
Ensuring safe and
sterile
administration of
vaccines to
prevent
infections.

8. Dr Asif Khan
Dr Asif Khan
Criteria for Selection in NLEM
Evidence-Based
The selection is based on scientific evidence
of efficacy and safety.
Disease Burden
Medicines for diseases causing significant
morbidity and mortality are prioritized.
Cost-Effectiveness
Consideration of the cost and cost-
effectiveness of the medicines.
Public Health Impact
Emphasis on medicines that address public
health needs and provide significant health
benefits.
Dr Asif Khan

9. Dr Asif Khan
Dr Asif Khan
NLEM 2022 updates
• Additions: New medications added to address emerging
healthcare needs.
• Removals: Deprecated or less effective drugs removed from the list.
• Revisions: Updates to existing entries based on latest research
and efficacy data.
Dr Asif Khan

10. Dr Asif Khan
Dr Asif Khan
Comparison: WHO EML vs. NLEM
WHO EML
The World Health Organization's Essential
Medicines List aims to identify the most
essential medicines for a functioning
healthcare system worldwide.
-> Insulin & Metformin – classified as anti
diabetics
NLEM
The National List of Essential Medicines is
tailored to the specific healthcare needs and
priorities of a particular country or region.
-> Insulin & Metformin – classified as
Hormones
Dr Asif Khan

11. Dr Asif Khan
Dr Asif Khan
Need for NLEM
The National List of Essential Medicines (NLEM) is essential to ensure
the availability and accessibility of vital medications for a population's
health needs.
It addresses the necessity for affordable and quality medicines, especially
for vulnerable and marginalized communities.
Dr Asif Khan

12. Dr Asif Khan
Dr Asif Khan
Benefits of NLEM inclusion
Access to Essential Medicines
NLEM inclusion ensures access to critical
and life-saving medications for the
population.
Regulated Pricing
It helps control the prices of essential
medicines, making them more affordable
and accessible.
Quality Assurance
NLEM listing ensures that the medicines
meet the required standards of quality and
effectiveness.
Healthcare Equity
It promotes equity by ensuring that
everyone has access to necessary
medications, regardless of their financial
status.
Dr Asif Khan

13. Dr Asif Khan
Dr Asif Khan
Limitations of NLEM
The limitations of the NLEM include the potential for outdated listings, difficulty in keeping up with
emerging drugs, and challenges in standardizing the list across diverse healthcare settings. Additionally,
there may be issues with accessibility and affordability of essential medicines included in the list.
Dr Asif Khan

14. Dr Asif Khan
Dr Asif Khan
Impact of NLEM on healthcare
1 Access to Essential Medicines
NLEM ensures availability of crucial medications, improving healthcare access.
2 Cost Reduction
By regulating prices of essential medicines, NLEM minimizes financial burden on
patients.
3 Quality Standards
NLEM inclusion promotes adherence to quality standards, enhancing patient safety.
Dr Asif Khan

15. Dr Asif Khan
Dr Asif Khan
Challenges in implementing NLEM
1
Resistance to Change
Medical practitioners may resist changes to familiar medications.
2
Supply Chain Disruption
Disruptions in the supply chain may affect medication availability.
3
Pricing and Affordability
Ensuring affordable prices for essential
medicines can be challenging.
Implementing the NLEM may face challenges such as resistance to change from medical practitioners,
disruptions in the supply chain affecting medication availability, and ensuring affordable pricing for
essential medicines.
Dr Asif Khan

16. Dr Asif Khan
Dr Asif Khan
The Future of Essential Medicines List
(EML)
Innovation
New advancements in
pharmaceuticals and
healthcare
Global Access
Ensuring equitable
access to essential
medicines worldwide
Research &
Development
Ongoing efforts in
developing new
essential medicines
Healthcare
Integration
Integration of
essential medicines
into healthcare
systems
Dr Asif Khan

17. Dr Asif Khan
Dr Asif Khan
Dr Asif Khan