Abstract
How can such evidences help patients and the health system in Bhutan? Bhutan has a three-tiered health system that guides resource allocation such as the availability of medicines, testing facilities and placement of doctors. Warfarin is available only at the National and Regional Referral Hospitals through the Essential Medicines Essential Medicines List 20165. With improved socioeconomic conditions and easier access to transport, many patients bypass the referral system and access health in tertiary care centres for diagnosis of conditions and follow up treatment in nearest local hospitals. Doctors are now available in primary level hospitals leading to early diagnosis of medical conditions and prescription of wider ranges of medicines. SGLT2 inhibitors and novel oral anticoagulants can be made available for prescription through the Essential Medicines List at the primary care levels so that patients in rural areas have better disease outcomes in a context where there is relatively lesser monitoring available. Newer developments in medical science offers avenues and opportunities for the National Essential Medicines List play crucial roles in improving patient care and treatment outcomes within the context of the Bhutanese health system.
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