Abstract
ABSTRACT Background: Drugs for cancer management constitute a large part of essential medicine lists (EMLs) prepared by many countries globally. Here, we compared anticancer drugs suggested by the World Health Organization (WHO) as essential medicines and the extent to which Government of India (GOI) included them in the National list of essential medicines (NLEMs). Aim: The current study was carried out to reiterate the importance of effective alternatives listed in the WHO-EMLs to all the members of core committee under Ministry of Health and Family Welfare, GOI, and inclusion of cost-effective targeted anticancer drugs in the NLEMs at regular intervals. Materials and Methods: A descriptive, observational study was conducted to analyze the essential anticancer drugs included in the WHO-EMLs and NLEMs published during the period 2015–2023. A total of 7 EMLs (5 from WHO and 2 from India) were included in the study. The collected data were assessed for the number of cytotoxic drugs, targeted drugs, immunomodulators, and hormonal drugs recommended treating various types of cancers. Microsoft Office Excel 2007 was used for tabulation and analysis. Descriptive statistics were used for the analysis. Results: Compared with NLEMs, the WHO-EMLs included more number of cytotoxic drugs (33 vs. 29). Except for the year 2015, where more number of targeted anticancer drugs were designated as essential medicines by the GOI (6) compared to the WHO (4), subsequent EMLs from the WHO (2019–2023) included more targeted drugs (10 in 2019, 12 in 2021, and 2023 respectively). We also witnessed substantial increase in the number of immunomodulators and hormonal agents used for cancer management in the latest editions of WHO-EMLs (4,15) as compared to the NLEMs (2,8). Conclusion: Targeted anticancer drugs, including immunomodulators and hormonal agents, are more efficacious with high response rates compared to the conventional cytotoxic drugs. Efforts to include them in the Indian-EMLs must be enhanced to cope up with the pace of WHO-EMLs. Special emphasis must be given to the economical therapeutic substitutes such as dasatinib, included in the WHO-EMLs that are effective against resistant cancers.
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