Essential Drug List - EDL
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The Essential Drug List (EDL), also known as the Essential Medicines List (EML), is one of the most important public health strategies introduced to improve access to medicines worldwide.
- essential medicines
- essential drug list
- WHO
- medicine accessibility
- public health
Text of these slides
- Slide 1. ESSENTIAL DRUG LIST Presented by Dr. Ayesha Fatima Assistant Professor Dept of Pharmacy Practice
- Slide 2. WHO Definition Essential drugs are those that satisfy the health care needs of the majority of the population which is available at all times in adequate amounts & in appropriate dosage forms. The model list of essential drugs is important in developing countries because of the reasons: 1. Development of treatment guidelines 2. Development of national formularies 3. Measures to improve drug use information for patients & general public
- Slide 3. • This is a very vibrant and progressive concept, as it needs to regularly update on the selection of medicines on the list based on current evidence, changes in resistance patterns of organisms, emerging diseases, newer molecules, and improved formulations are all taken into account. • To have a limited range of carefully selected core essential medicines, leading to better healthcare, better drug management, and lower costs. • To satisfy the priority healthcare needs of the population of the target country/state. • They are selected due to disease prevalence, evidence of efficacy and safety, and comparative cost-effectiveness. Concept of EML
- Slide 4. Guidelines For Establishing A National Programme For Essential Drug List 1. A national drug authority should be established 2. A National Drugs & Therapeutics Committee (DTC) should be established 3. Generic names should be used for all drugs 4. A concise, accurate & comprehensive drug information booklet should be prepared 5. The quality of all products, including stability & bioavailability, should be assured throughout product registration process 6. Competent health authorities should decide on the level of expertise needed to prescribe drugs 7. Efficient administration of supply, storage & distribution of drugs in the essential drug list, is indeed required for the success of ED programme 8. There should be a well-documented procurement policy, based on records of turnover of drugs 9. Research, both clinical & pharmaceutical, is sometimes needed to settle a choice of a particular drug under local conditions
- Slide 5. Choice of essential drugs depends on many factors like 1. Pattern of prevalent diseases in the country 2. Treatment facilities available 3. Level of training & experience of the personnel, who will actually handle the drugs 4. Financial resources available in the country 5. Genetic, demographic & environmental factors Criteria For The Selection Of Essential Drugs
- Slide 6. 1. Evidence-based; not situation based 2. Selected drugs should have sound & adequate data on their efficacy & safety, based on clinical studies 3. Performance of a drug in general use has been proved in variety of medical settings 4. Each selected drug must be available in adequate quantities & in the dosage form that is recommended by DTC 5. It must have assured quality, including bioavailability & stability, under various conditions prevailing in the country 6. When 2 or more drugs appear to be similar in quality, bioavailability, stability, choice should be made on the basis of careful evaluation of their relative efficacy, safety, quality, price & availability 7. When cost becomes an issue in the selection of drugs, only the unit cost of the drug alone should not be considered 8. Comparative pharmacokinetic properties of drugs in the same therapeutic category, proves helpful for the choice 9. Local facilities to manufacture drugs or their storage should also be considered 10. ED’s should contain only one single basic drug or active ingredient Selection of essential drugs must always be
- Slide 7. Advantages of EML ● In developing countries, most deaths occur from treatable causes such as diarrhea, pneumonia, neonatal sepsis, and so on. ● If the medicines needed to treat these conditions were available in the health facilities at an affordable price, in sufficient quantity and good quality, and reached those who needed them, then a large proportion of these deaths would be prevented. ● Having a limited list also makes procurement easier ● Keeping track of a smaller number of medicines and preventing stock-outs becomes easier. ● If the public health facilities are spread over a large geographical area, transporting a smaller number of medicines in the required quantities is easier. ● The most important advantage is to the doctors who prescribe the medicines and to the pharmacists who dispense them. With a restricted list, doctors and pharmacists can acquire an in-depth knowledge of the clinical pharmacology of the drugs and make sure that they are used appropriately. ● Pharmacists can counsel patients on the optimal use of the medicine.
- Slide 8. ● It is difficult to see any disadvantage in a carefully selected list based on transparent criteria; the objections are based on criteria other than health. ● Doctors may resent having to prescribe from the list and believe that their right to prescribe whatever they want is taken away. ● Ironically, doctors in low- and middle-income countries may have the freedom to prescribe what they want, from the medicines available in the country. ● However, doctors in high-income countries do not have this freedom and must prescribe from the list that has been approved by their healthcare system. ● The British National Formulary shows that only five benzodiazepines are available in the National Health Service in the UK, whereas many more are registered. ● The high-income countries have adopted the principles of the Essential Medicines Concept as enthusiastically as the low and middle-income countries, though the lists themselves have other names. ● The pharmaceutical industry has a strong commercial interest in having many medicines in the market. The industry does not like limited lists, especially those based on transparent criteria. Hence, there has been persistent opposition from the very beginning to this concept. This is a classic example of the irreconcilable role of health and commerce in medicine. Disadvantages of EML
- Slide 9. References 1. A Textbook Of Clinical Pharmacy Practice Second Edition By G Parthasarathi 2. Clinical Pharmacy By Tippins
