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Essential medicines, as defined by the World Health Organization are "those drugs that satisfy the health care needs of the majority of the population; they should therefore be available at all times in adequate amounts and in appropriate dosage forms, at a price the community can afford." The WHO has published a model list of essential medicines. Each country is encouraged to prepare their own lists taking into consideration local priorities. At present over 150 countries have published an official essential medicines list. The WHO List contains a core list and a complementary list. The core list presents a list of minimum medicine needs for a basic health care system, listing the most efficacious, safe and cost-effective medicines for priority conditions. Priority conditions are selected on the basis of current and estimated future public health relevance, and potential for safe and cost-effective treatment. The complementary list presents essential medicines for priority diseases, for which specialized diagnostic or monitoring facilities are needed. In case of doubt medicines may also be listed as complementary on the basis of consistent higher costs or less attractive cost-effectiveness in a variety of settings. The compilation of an essential medicines list enables health authorities, especially in developing countries, to optimize pharmaceutical resources. The list is important because:
Essential medicines: theory and practiceThe original 1977 WHO definition of “essential medicines” was that they were ‘of utmost importance, basic, indispensable, and necessary for the healthcare needs of the population’.1 The concept was mentioned in one of the ten points of the 1978 Alma Ata Declaration on primary health care. The difficulty of putting this into practice is reflected in the rather longer and more categorical 2002 definition:
The WHO Model List of Essential Medicines has been updated every two years since 1977. The current version, the 15th list, dates from March 2007. Cost-to-benefit ratioCost effectiveness is difficult to define and is the subject of fierce debate between producers (pharmaceutical companies) and purchasers of drugs (national health services). Number of drugsThe number of drugs has nearly doubled, from 186 in 1977 to 320 in 2002. The range has increased substantially over the years and now includes antimigraine drugs, antidotes, and antineoplastic drugs. See also
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