The document summarizes the concept, criteria for selection, benefits, and application of essential medicines in Nepal. Essential medicines are those that satisfy the priority health needs of the population and are intended to be available at all times in adequate amounts and appropriate forms at a price people can afford. Nepal first implemented a national list of essential medicines in 1986 based on WHO guidelines. The list is revised every few years to ensure availability of effective, safe, and affordable medicines aligned with treatment guidelines.

1. Seminar on
Essential Medicines: Concept, criteria for selections,
benefits and application in Nepal
Under cordial guidance of
Hari Prasad Kaphle
Advisor
Associate Professor (Public Health)
PU, SHAS
By
Pragya Banstola
At Faculty of Health Sciences
Pokhara University
2019

2. Concept
• Essential medicines are those medicines that satisfy
the priority health care needs of the population and
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
at price the individual and the community can
afford
DDA. National List of Essential Medicines Nepal(Fifth
Revision). Department of Drug Administration 2016.

3. • WHO published the first essential medicine list in
1977.
• In Nepal, program with a first ever National List of
Essential Medicines, implemented in 1986.
• Since then NLEM revised five times (1992, 1997,
2002, 2011 and 2016) with the support from WHO
Nepal.
DDA. National List of Essential Medicines Nepal(Fifth
Revision). Department of Drug Administration 2016.

4. • During preparation of the NLEM consultation with
concerned institutions and experts is done.
• Then a formal process for the approval of the list by
the government is initiated.
• Experts are requested to provide their comments at
the earliest for further improvement of this list.
DDA. National List of Essential Medicines Nepal(Fifth
Revision). Department of Drug Administration 2016.

5. Criteria for selections of essential
medicine
• Approved/licensed medicine in the country
• Relevance for disease posing public health problem
• Proven efficacy and safety profile based on valid
scientific evidence
• Cost effective
• Aligned with STG (the current treatment guidelines
under public health program)
DDA. National List of Essential Medicines Nepal(Fifth
Revision). Department of Drug Administration 2016.

6. • Stable under the storage conditions
• Preference on relative safety, efficacy, cost-
effectiveness
• Fixed Dose Combinations (FDCs)
• Access
DDA. National List of Essential Medicines Nepal(Fifth
Revision). Department of Drug Administration 2016.

7. Benefits
• Careful selection of a limited range of essential
medicine results in :-
a higher quality of care,
better management of medicines
more cost-effective use of health resources
improved quality of prescribed medicines
WHO. The Selection of Essential Medicines. Geneva: World
Health Organization,2002.

8. result in real health gains
 increased public confidence and belief in the health
services
promote the rational use of medicine
WHO. The Selection of Essential Medicines. Geneva: World
Health Organization,2002.

9. Application in Nepal
• The first ever application of essential medicine program
in Nepal was in 1986.
• Providing pharmaceutical care and concept of essential
medicine has become important.
• Government of Nepal has announce essential medicine
at health post, primary healthcare center and district
hospital.
DDA. National List of Essential Medicines Nepal(Fourth
Revision) Final Draft. Department of Drug Administration
2009.

10. • Medicines in the national list are categorized as
main and complementary.
• The complementary list presents essential medicines
for priority diseases.
• Institutions should decide on individual basis
whether these medicines are necessary to make
available at present.
DDA. National List of Essential Medicines Nepal(Fourth
Revision) Final Draft. Department of Drug Administration
2009.

11. • There were 321 medicines listed in NLEM 2011.
• The new list of NLEM 2016 thus contains 359
medicines.
• NLEM is edited as per the need of the people’s
health.
DDA. National List of Essential Medicines Nepal(Fifth
Revision). Department of Drug Administration 2016.

12. Refrences
DDA. National List of Essential Medicines
Nepal(Fifth Revision). Department of Drug
Administration 2016.
WHO. The Selection of Essential Medicines.
Geneva: World Health Organization,2002.
DDA. National List of Essential Medicines
Nepal(Fourth Revision) Final Draft. Department of
Drug Administration 2009.