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Accessibility and use of essential medicines in health care: Current progress and challenges in India.

Bansal D, Purohit VK - J Pharmacol Pharmacother (2013)

Bottom Line: Appropriate use of essential medicines is one of the most cost-effective components of modern health care.Health expenditure is less in India as compared to developed countries.There is a need to develop strategies to improve affordable access to essential medicines under the current health care reform.

View Article: PubMed Central - PubMed

Affiliation: Department of Pharmacy Practice, National Institute of Pharmaceutical Education and Research, Sector-67, Mohali, Punjab, India.

ABSTRACT
Essential Medicine Concept, a major breakthrough in health care, started in 1977 when World Health Organization (WHO) published its first list. Appropriate use of essential medicines is one of the most cost-effective components of modern health care. The selection process has evolved from expert evaluation to evidence-based selection. The first Indian list was published in 1996 and the recent revision with 348 medicines was published in 2011 after 8 years. Health expenditure is less in India as compared to developed countries. India faces a major challenge in providing access to medicines for its 1.2 billion people by focusing on providing essential medicines. In the future, countries will face challenges in selecting high-cost medicines for oncology, orphan diseases and other conditions. There is a need to develop strategies to improve affordable access to essential medicines under the current health care reform.

No MeSH data available.


Related in: MedlinePlus

ATC Classification[25] of drugs in WHO EML (2011) and India EML (2011) *Items that are not included in ATC classes (e.g., coal tar, calamine, cryoprecipitate, etc.) †Total number of medicines is more than that of present in EML because some drugs are categorized in more than one class
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Figure 2: ATC Classification[25] of drugs in WHO EML (2011) and India EML (2011) *Items that are not included in ATC classes (e.g., coal tar, calamine, cryoprecipitate, etc.) †Total number of medicines is more than that of present in EML because some drugs are categorized in more than one class

Mentions: EM concept is somewhat new to India. Tamil Nadu was the first state to develop EML in 1994.[9] The Delhi state drug policy was adopted in 1994. The first NEML was prepared in 1996.[23] This list was neither implemented for procuring drugs nor STGs were drawn up.[24] The first and second revision was published in 2003 and 2011, respectively. NEML 2011 was revised based on the Indian Pharmacopeia 2010 and the National Formulary of India, 4th edition, 2010. The workshop entitled “Expert Group Meeting on Revision and Updating of the National List of Essential Medicines” was organized in September 2009 and the first meeting of core committee was held at CDSCO in July 2010. Further two meetings of core committee at CDSCO in 2011 resulted in NEML 2011. Unlike WHO EML and 2003 edition of Indian EML, there is no provision of complementary list in the current edition. NEML 2003 had some complementary medicines included in the core list itself. The current list is also divided according to various levels of medical care. The Government of India, Ministry of Health and Family Welfare (MOHFW) is responsible for preparing the EML.[11] The current 3rd edition (2011) has 348 medicines and 653 formulations and dosage forms. Forty-seven drugs included in the previous list have been removed and 43 new drugs are being added in the current list.[11] It contains 14 medicines for HIV/AIDS and 33 oncology medicines. There is a difference in the number of drugs according to WHO Anatomical Therapeutic Classification (ATC) between WHO and NEML of India [Figure 2]. India doesn′t have a separate list for children. However, Indian Academy of Pediatrics (IPA) has published EML for children in 2011 (1st edition) with 134 medicines.[26]


Accessibility and use of essential medicines in health care: Current progress and challenges in India.

Bansal D, Purohit VK - J Pharmacol Pharmacother (2013)

ATC Classification[25] of drugs in WHO EML (2011) and India EML (2011) *Items that are not included in ATC classes (e.g., coal tar, calamine, cryoprecipitate, etc.) †Total number of medicines is more than that of present in EML because some drugs are categorized in more than one class
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3643337&req=5

Figure 2: ATC Classification[25] of drugs in WHO EML (2011) and India EML (2011) *Items that are not included in ATC classes (e.g., coal tar, calamine, cryoprecipitate, etc.) †Total number of medicines is more than that of present in EML because some drugs are categorized in more than one class
Mentions: EM concept is somewhat new to India. Tamil Nadu was the first state to develop EML in 1994.[9] The Delhi state drug policy was adopted in 1994. The first NEML was prepared in 1996.[23] This list was neither implemented for procuring drugs nor STGs were drawn up.[24] The first and second revision was published in 2003 and 2011, respectively. NEML 2011 was revised based on the Indian Pharmacopeia 2010 and the National Formulary of India, 4th edition, 2010. The workshop entitled “Expert Group Meeting on Revision and Updating of the National List of Essential Medicines” was organized in September 2009 and the first meeting of core committee was held at CDSCO in July 2010. Further two meetings of core committee at CDSCO in 2011 resulted in NEML 2011. Unlike WHO EML and 2003 edition of Indian EML, there is no provision of complementary list in the current edition. NEML 2003 had some complementary medicines included in the core list itself. The current list is also divided according to various levels of medical care. The Government of India, Ministry of Health and Family Welfare (MOHFW) is responsible for preparing the EML.[11] The current 3rd edition (2011) has 348 medicines and 653 formulations and dosage forms. Forty-seven drugs included in the previous list have been removed and 43 new drugs are being added in the current list.[11] It contains 14 medicines for HIV/AIDS and 33 oncology medicines. There is a difference in the number of drugs according to WHO Anatomical Therapeutic Classification (ATC) between WHO and NEML of India [Figure 2]. India doesn′t have a separate list for children. However, Indian Academy of Pediatrics (IPA) has published EML for children in 2011 (1st edition) with 134 medicines.[26]

Bottom Line: Appropriate use of essential medicines is one of the most cost-effective components of modern health care.Health expenditure is less in India as compared to developed countries.There is a need to develop strategies to improve affordable access to essential medicines under the current health care reform.

View Article: PubMed Central - PubMed

Affiliation: Department of Pharmacy Practice, National Institute of Pharmaceutical Education and Research, Sector-67, Mohali, Punjab, India.

ABSTRACT
Essential Medicine Concept, a major breakthrough in health care, started in 1977 when World Health Organization (WHO) published its first list. Appropriate use of essential medicines is one of the most cost-effective components of modern health care. The selection process has evolved from expert evaluation to evidence-based selection. The first Indian list was published in 1996 and the recent revision with 348 medicines was published in 2011 after 8 years. Health expenditure is less in India as compared to developed countries. India faces a major challenge in providing access to medicines for its 1.2 billion people by focusing on providing essential medicines. In the future, countries will face challenges in selecting high-cost medicines for oncology, orphan diseases and other conditions. There is a need to develop strategies to improve affordable access to essential medicines under the current health care reform.

No MeSH data available.


Related in: MedlinePlus