A comparison of national essential medicines lists in the Americas

Abstract

Objectives. To compare national essential medicines lists (NEMLs) from countries in the Region of the Americas and to identify potential opportunities for improving those lists. Methods. In June of 2017, NEMLs from 31 countries in the Americas were abstracted from documents included in a World Health Organization (WHO) repository. The lists from the Americas were compared to each other and to NEMLs from outside of the Americas, as well as with the WHO Model List of Essential Medicines, 20th edition (“WHO Model List”) and the list of the Pan American Health Organization (PAHO) Regional Revolving Fund for Strategic Public Health Supplies (“Strategic Fund”). Results. The number of differences between the NEMLs from the Americas and the WHO Model List were similar within those countries (median: 295; interquartile range (IQR): 265 to 347). The NEMLs from the Americas were generally similar to each other. While the NEMLs from the Americas coincided well with the Strategic Fund list, some medicines were not included on any of those NEMLs. All the NEMLs in the Americas included some medicines that were withdrawn due to adverse effects by a national regulatory body (median: 8 withdrawn medicines per NEML; IQR: 4 to 12). Conclusions. The NEMLs in the Americas were fairly similar to each other and to the WHO Model List and the Strategic Fund list. However, some areas of treatment and some specific medicines were identified that the countries should reassess when revising their NEMLs.

Uma proposta de ontologia para a Assistência Farmacêutica a partir das páginas da Revista Ciência & Saúde Coletiva

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“…A recent study by Steiner et al. asserted that because of robust overlap between countries’ National Essential Medicines Lists (NEML) and those with a negotiated price through the Strategic Fund lists, the mechanism “may be influential in its intended goal of helping countries to improve access to some medicines” while helping to make medicines for both communicable and non-communicable diseases more affordable [10] .…”

“…Notably, the Strategic Fund has one of the most comprehensive lists of essential medicines and public health supplies offered in the Americas Region. In addition, Steiner et al.’s review found that the Strategic Fund's Medicines List included a greater variety of medicines than any of the NEMLs throughout LAC, and even recommended adapting NEMLs to the Strategic Fund list [10] .…”

“…The mechanism is already unique in offering critical treatments for chronic illnesses, including hypertension, cancer, diabetes, and mental health conditions. Related research has indicated that leveraging the Strategic Fund's technical cooperation and effectiveness in pooled procurement may “lead to improvements in measurable health outcomes and ultimately better the health of people in the Americas ” [10] . This will be vital if countries are to feasibly achieve their priority health objectives and SDG commitments, as well as ensure universal access to health – especially as non-communicable diseases currently account for 81% of total deaths in the region [15] .…”

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“…Compounding this is the emergence of multi-drug resistant TB (MDR-TB) and extensively drug-resistant TB (XDR-TB) which incur higher treatment costs compared to drug-sensitive TB (DS-TB) [1] , [2] . Providing access to appropriate and essential TB medicines – medicines selected for their quality, safety, efficacy and cost-effectiveness [7] , [8] , [9] – should improve TB population health outcomes [1] , [10] .…”