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The World Health Organization Releases Guide to Update National Essential Medicines Lists

WHO Guide ‘Selection of Essential Medicines at Country Level: Using the WHO Model List of Essential Medicines to update a national essential medicines list’
07 Apr 2020

To support countries with their selection of essential medicines, the WHO published a new user guide ‘Selection of Essential Medicines at Country Level: Using the WHO Model List of Essential Medicines to update a national essential medicines list’. The document is intended for use by policymakers responsible for the national medicines and reimbursement lists, and aims to provide insight into how essential medicines should be selected.

The WHO’s new Guide on Selection of Essential Medicines outlines key actions countries should implement to ensure their national essential medicines lists (NEMLs) are carefully developed and updated based on their population’s treatment needs, and the health system’s reimbursement capacities. The WHO Guide incorporates  the use of the ESMO-Magnitude of Clinical Benefit Scale (ESMO-MCBS) as part of WHO’s guiding principles for inclusion of cancer medicines on the WHO EML. This acknowledges the importance of the work the ESMO Magnitude of Clinical Benefit Working Group and the Cancer Medicines Committee are doing to ensure accessibility and availability of vital anti-cancer medicines for cancer patients across the world. The WHO Guide also notes that NEMLs are a fundamental tool for achieving universal health coverage (UHC).

In the WHO Guide, the cancer medicines on the 2019 WHO Model List of Essential Medicines (EML), and the indications for which they are recommended, are listed in the tables on page 26-27. WHO recommends that any modification on an NEML should be done in consultation with relevant stakeholders in charge of developing national clinical practice guidelines for patient treatment.

The WHO Guide aligns with the recommendations in the Economist Intelligence Unit (EIU) and ESMO report on Cancer Medicines Shortages in Europe: Policy recommendations to prevent and manage shortages, which calls for all countries to develop a national essential medicines list based on the WHO EML. Cancer medicines on the WHO EML are used in the treatment of the majority of cancers, and are recommended in the evidence-based ESMO Clinical Practice Guidelines that medical oncologists use to treat their patients.

For medicines that have not been considered by the WHO Expert Committee, WHO asks National Selection Committees to consider deferring a decision and referring evaluation to the WHO EML Secretariat.

WHO Model List of Essential Medicines

Since 1977, the World Health Organization (WHO) has been continuously developing and disseminating the WHO Model List of Essential Medicines (EML), which is updated every two years.

The WHO concept of essential medicines focuses on:

  • Medicines that satisfy the priority health care needs of the population
  • Medicines selected with due regard to disease prevalence and public health relevance, evidence of efficacy and safety, and comparative cost-effectiveness
  • Medicines 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 community can afford

The WHO assists countries with developing their own national essential medicines lists (national EMLs or NEMLs), that are consistent with the evidence-based methods used to update the WHO Model List.

Countries are encouraged to submit updated copies of their NEMLs for inclusion in the WHO National Essential Medicines Lists (NEMLs) Repository. Currently, 138 NEMLs are publicly available online through the repository.

The WHO EML only lists medicines that have proven safety and efficacy. The WHO recommends that decision-makers refer to the global list to ensure their national lists reflect the public health value of medicines for their populations. Most countries have national essential medicines lists, however, they are quite different when compared with the WHO’s list. To allow countries to compare their NEMLs to the WHO EML, the WHO supported the development of an online Global Essential Medicines Dashboard, where and interactive world map shows countries and their national essential medicines lists, and indicates which medicines are on the WHO EML and which are not.

The WHO also recently developed an electronic version of the WHO EML (eEML) in order to make the global list freely and more readily accessible.

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