Similarities and Differences in Essential Medicines Lists of 137 Countries: A Quantitative Analysis

Persaud, Nav; Jiang, Maggie; Shaikh, Roha; Bali, Anjli; Oronsaye, Efosa; Woods, Hannah; Drozdzal, Gregory; Rajakulasingam, Yathavan; Maraj, Darshanand; Wadhawan, Sapna; Umali, Norman; McCall, Marcy; Aronson, Jeffrey K; Plüddemann, Annette; Moja, Lorenzo; Magrini, Nicola; Heneghan, Carl

doi:10.2139/ssrn.3225485

Cited by 2 publications

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“…We also found that nearly all countries (median 100%) included all 9 HEARTS medicines on their national EML (including 4 medicines for secondary prevention of cardiovascular disease), where only about half of countries examined in the other study included all four secondary prevention medicines [6]. Differences in the study approach were that our analysis did not compare EML listings based on country income classifications and included more recent versions of national EMLs as found in the WHO Repository (up to 2017, compared to up to 2015) [7, 16]. The differences in findings are thus likely explained by additional countries adding aspirin and statins to their national EML since 2015, our inclusion of a wider range of dosages, and the inclusion of high-income country EMLs in our study.…”

Section: Discussionmentioning

confidence: 99%

“…Five country characteristics were collected for the 137 countries with national EMLs [13]: geographic region, population size, gross domestic product (GDP) per capita, publication date, and number of medicines on each national EML [see S1 Table]. Data on geographic region and health expenditure per capita was collected from the Global Health Observatory of the WHO (2018) using the most recent information available at the time [14].…”

Section: Methodsmentioning

confidence: 99%

“…Medicines were listed individually using International Nonproprietary Names without regard for salts, doses, or formulations. Saline solutions, diagnostic agents, antiseptics, and disinfectants were excluded from the database [16]. We assumed that the medicines in the same chemical subgroup as the exemplar were equivalent (e.g.…”

Section: Methodsmentioning

confidence: 99%

“…perindopril was considered equivalent to ramipril). All national EMLs were evaluated regardless of language of origin or publication date and a tally of all medications was done for individual lists [16]. We determined whether each national EML covered each priority medicine or class across the selected interventions.…”

Section: Methodsmentioning

confidence: 99%

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Selection of WHO-recommended essential medicines for non-communicable diseases on National Essential Medicines Lists

et al. 2019

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Background Non-communicable diseases (NCDs) are the leading cause of death worldwide. Inadequate and inequitable access to essential NCD medicines is a major concern, particularly in low- and middle-income countries. National Essential Medicines Lists (EMLs) are important policy tools that indicate which medicines are prioritized as essential within a country’s health system. This study sought to analyze a wide range of national essential medicines lists (EMLs) for their inclusion of priority non communicable disease (NCD) interventions recommended by the World Health Organization (WHO). Methods Three lists of WHO endorsed priority NCD interventions were included. A database with 137 national EMLs and the WHO EML was created from the WHO Repository and these EMLs were compared for listing of priority NCD interventions. Results Across 137 countries with national EMLs, the median percentage of 20 Best Buys interventions listed was 90% (IQR 80–95) and 31 Package of essential noncommunicable disease interventions (PEN) interventions listed was 94% (IQR 90–97), of 9 HEARTS interventions was 100% (IQR 89–100), and of the 43 unique interventions across the three priority lists was 88% (IQR 84–93). Less than 80% of the 43 interventions were listed by 22 (16%) countries and less than half of the interventions were listed by 2 countries: Angola (35%) and Cambodia (23%). Interventions listed on the fewest number of national EMLs were: influenza vaccine, HPV vaccine, hepatitis B vaccine, cervical cancer chemotherapy, codeine, promethazine, senna, and oxygen. Conclusion Most NCD interventions have been prioritized in national policy in most cases. The majority of priority medicines for NCDs described within key WHO NCD technical packages are listed on nearly all national EMLs across 137 countries of all income levels. Most NCD interventions have been prioritized in national policy in most cases, but in some countries and for select interventions such as the HPV vaccine, prioritization may be reviewed.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Selection of WHO-recommended essential medicines for non-communicable diseases on National Essential Medicines Lists

et al. 2019

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“…Vitamin K antagonists appear on most SSA countries' essential medicine lists 64 . Warfarin is the most commonly used, followed by acenocoumarol 64,65 .…”

Section: Challenges Accessing Anticoagulationmentioning

confidence: 99%

Improving anticoagulation in sub‐Saharan Africa: What are the challenges and how can we overcome them?

Mouton

Blockman

Sekaggya-Wiltshire

et al. 2021

Brit J Clinical Pharma

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Patients in sub-Saharan Africa generally have poor anticoagulation control. We review the potential reasons for this poor control, as well as the potential solutions.Challenges include the affordability and centralisation of anticoagulation care, problems with access to medicines and international normalised ratio monitoring, the lack of locally validated standardized dosing protocols, and low levels of anticoagulation knowledge among healthcare workers and patients. Increasing numbers of patients will need anticoagulation in the future because of the increasing burden of noncommunicable disease in the region. We propose that locally developed "warfarin care bundles" which address multiple anticoagulation challenges in combination may be the most appropriate solution in this setting currently.

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Similarities and Differences in Essential Medicines Lists of 137 Countries: A Quantitative Analysis

Cited by 2 publications

References 0 publications

Selection of WHO-recommended essential medicines for non-communicable diseases on National Essential Medicines Lists

Selection of WHO-recommended essential medicines for non-communicable diseases on National Essential Medicines Lists

Improving anticoagulation in sub‐Saharan Africa: What are the challenges and how can we overcome them?

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