Abstract
International Journal of Medicine and Public Health,2015,5,1,71-76.DOI:10.4103/2230-8598.151266Published:January 2015Type:Original ArticleA comparative review of the list of essential medicines of three Indian states: Findings and implicationsVenkatesh Narayan, Maulik Chokshi, and Habib Hasan Venkatesh Narayan, Maulik Chokshi1, Habib Hasan1 International Clinical Epidemiology Network, 1Indian Institute of Public Health, New Delhi, India Abstract:Introduction: Essential medicines lists are a key instrument for improving quality and equitable access to health care. The National List of Essential Medicines of India 2011 is modeled on the WHO Essential Medicines List and Indian states (adopting the National List) are free to include other medicines as needed. Materials and Methods: National List of Essential Medicines of India 2011 contains a total of 287 medicines for provision at primary and secondary level of health facilities. The International Nonproprietary Name of these medicines was compared with the List of Essential Medicines (LEM) of three states, that is, Bihar, Rajasthan and Tamil Nadu for the inclusion patterns. Results: A large number of medicines from the National List of Essential Medicine (NLEM) were missing from the state LEM’s, especially Bihar. The sections on Anticonvulsants, Diuretics, Psychotherapeutic, Antiallergics and Oxytocics were comprehensively included by both Rajasthan and Tamil Nadu. Furthermore, the analgesic and anti-infective medicines were largely included. However, the sections of antidotes, diagnostic agents and ophthalmological preparations were grossly deficient. Similarities were found across states in their patterns of both inclusion and exclusion of medicines. Conclusion: The analysis reveals that the extent of inclusion of NLEM medicines in state LEM’s is deficient with variable patterns across states. This in turn has implications for drug availability, prescription patterns, and rational drug use. As some drugs are repeatedly there in NLEM but not included by states, a discussion based consultative approach for better coherence across the lists could lead to further optimization and utilization of LEM’s which would aid in improved access to medicines. Keywords:Essential medicines, inclusion of medicines, India essential medicine listView:PDF (507.02 KB)
Highlights
WHO defines Essential medicines as those that satisfy the health care needs of the majority of the population and are selected with due regard to public health relevance, evidence on efficacy and safety, and comparative cost-effectiveness.[1]
The analysis reveals that the extent of inclusion of National List of Essential Medicine (NLEM) medicines in state List of Essential Medicines (LEM)’s is deficient with variable patterns across states
WHO published the first WHO Model list of essential medicines (EML) in 1977 thereby providing a template which could help countries prepare their own lists[3] as emulated by the 17th WHO model EML 2011.[4]. The Indian National List of Essential Medicine (NLEM) preface states that it is modeled on the WHO EML
Summary
WHO defines Essential medicines as those that satisfy the health care needs of the majority of the population and are selected with due regard to public health relevance, evidence on efficacy and safety, and comparative cost-effectiveness.[1] Availability of a limited list of carefully selected essential medicines within the context of functioning health systems is among the key instruments to improve quality and equitable access to health care.[2] WHO published the first WHO Model list of essential medicines (EML) in 1977 thereby providing a template which could help countries prepare their own lists[3] as emulated by the 17th WHO model EML 2011.[4] The Indian National List of Essential Medicine (NLEM) preface states that it is modeled on the WHO EML. While comparative analysis of LEM’s has been carried out by few earlier studies, often, the focus is on specific sections[10,11] (such as Reproductive Health, Maternal and Child health) or an overall
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