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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 of people living in rural areas to drugs
• For poor and disadvantaged medicines are :
– Unavailable
– Unaffordable
– Unsafe
– Improperly used
• 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.
• 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.
Advantages
•
•
•
•
•
•

Limited range
High Quality care
Better management of medicines
More cost effective use of resources
Real health gains
Increased public confidence
• 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
• 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.
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.
• Factors such as
– Pattern of prevalent disease,
– Treatment facility,
– Training and experience of available personnel,
– Financial resources
– Genetic , demographic and environmental factors.
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
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
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
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
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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Who essential medicine concept

  • 1. WHO concept of essential medicines Dr. Gyanendra Raj Joshi PharmD, RPh
  • 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. • 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. • 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. Advantages • • • • • • Limited range High Quality care Better management of medicines More cost effective use of resources Real health gains Increased public confidence
  • 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. • 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. 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. • Factors such as – Pattern of prevalent disease, – Treatment facility, – Training and experience of available personnel, – Financial resources – Genetic , demographic and environmental factors.
  • 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.
  • 12. 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
  • 13. 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
  • 14. 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
  • 15. 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