NTA Level 5 • Semester 1 • PST05105

Concept of National Essential Medicines

Rational Use of Medicines • Source Session/Topic 6

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Session 6: Concept of National Essential Medicines

Total Session Time: 120 minutes

Prerequisites

• None

Students Learning Tasks

By the end of this session students are expected to be able to:

• Define essential medicine list

• Give overview of model list of essential medicines list

• Describe national concept of essential medicines list

• Outline advantages of a limited list of essential medicines

• Identify problems of national essential medicines list

Resources Needed:

• Flip charts, marker pens, and masking tape

• Black/white board and chalk/whiteboard markers

SESSION OVERVIEW

SESSION CONTENTS

STEP 1: Presentation of Session Title and Learning Tasks (05 Minutes)

READ or ASK students to read the learning objectives and clarify

ASK students if they have any questions before continuing.

STEP 2: Definition of Essential Medicines list (10 minutes)

• Essential medicines are those that satisfy the priority health care

needs of the population, they are selected with due regard to disease

prevalence and public health relevance, evidence of clinical efficacy

and safety, and comparative costs and cost-effectiveness.

STEP 3: Introduction of Model List of Essential Medicines (25 Minutes)

• The concept of essential medicines has been worldwide accepted as a

powerful tool to promote health equity and its impact is remarkable

as the essential medicines are proved to be one of the most cost-

effective elements in health care.

• World Health Organization (WHO) introduced the concept of essential

medicines in 1977 and develops the first essential medicines list in

1977 and since then the list has been revised every 2 years.

• Lists of essential medicines are also used by UNICEF, the United

Nations high commissioner for refugees, and many non-governmental

organizations.

• The WHO Model List of Essential Medicines is a useful reference,

derived from the consensus of recognized international experts and

updated.

• The model list of WHO serves as a guide for the development of

national and institutional essential medicine list. Both its content

and the process by which it is updated are intended as a model for

developing countries.

STEP 4: National Concept of Essential medicines list (30 minutes)

• Essential medicines are intended to be available within the context of

functioning health systems at all times in adequate amounts, in the

appropriate dosage forms, with assured quality and adequate

information, and at a price the individual and the community can

afford.

• The implementation of the concept of essential medicines is intended

to be flexible and adaptable to many different situations;

• Medicines which are regarded as essential remains a national

responsibility.

• Experience has shown that careful selection of a limited range of

essential medicines results in a higher quality of care, better

management of medicines (including improved quality of prescribed

medicines), and a more cost-effective use of available health

resources.

• Medicines are integral parts of the health care and the modern health

care is unthinkable without the availability of necessary medicines.

• They not only save lives and promote health, but prevent epidemics and

diseases too.

• The medicines are undoubtedly one of the weapons of mankind to fight

disease and illness. Accessibility to medicines is too the fundamental

right of every person.

STEP 3: Advantages of a Limited List of Essential Medicines(20 minutes)

|Activity: Brainstorming (10 Minutes) |

|Ask students to brainstorm on the following question: |

|What are the advantages of a limited list of essential medicines? |

|ALLOW few students to respond |

|WRITE their responses on the flip chart/ board |

|CLARIFY and SUMMARISE by using the content below |

The following are the advantages of having limited list of essential

medicines in different aspect:

Supply

Medicines and medical suppliers benefit by:

• Easier procurement, storage, and distribution

• Lower stocks

• Better quality assurance

• Easier dispensing

Prescribing and Dispensing

Pharmaceutical personnel and prescribers benefit it because:

• Training more focused and therefore simpler

• More experience with fewer medicines

• Non availability of irrational treatment alternatives

• Reduction of antimicrobial resistance

• Focused drug information

• Better recognition of adverse drug reactions

Cost

• Lower prices, more competition

Patient use

Patients and other consumers of medicines and medical suppliers benefit it

because they:

• Focused education efforts

• Reduced confusion and increased adherence to treatment

STEP 4: Problems of National Essential Medicine List (20 Minutes)

|Activity: Buzzing (10 Minutes) |

|Ask students to brainstorm on the following question: |

|What are the problems of national essential medicine list? |

|ALLOW few students to respond |

|WRITE their responses on the flip chart/ board |

|CLARIFY and SUMMARISE by using the content below |

The following are problems of national essential medicine list

• Range of diseases covered by the Model List is not clear

• Discrepancies between Model List and treatment guidelines

• Selection is more consensus-based than evidence-based

• Use of data on cost and cost-effectiveness unclear

• Reasons for selection is insufficiently recorded

• Drugs included without pharmacopoeia standard or supplier

• Official report comes out too late, and in English only

STEP 6: Key Points (05 Minutes)

• Establishing and using a limited list of carefully selected essential

medicines is perhaps the single most cost-effective action that any

health care system or health care provider can take to promote regular

supply and rational use of medicines.

• Patients can be better informed about the effective use of medicines when

the number of medicines they are confronted with is limited.

• Medicines and medical suppliers benefit with EML because of easier

procurement, storage, and distribution, lower stocks, better quality

assurance and easier dispensing

STEP 7: Evaluation (05 Minutes)

• Define essential medicines

• List advantages of a limited list of essential medicines

• How medicines and medical suppliers benefit from EML?

References:

Kar SS1,Pradhan HS2,Mohanta GP3, (2010). Concept of essential medicines and

rational use in public health.Indian Journal of Community Medicine.

Tripathi KD. (2010), Aspects of Pharmacotherapy; Clinical pharmacology and

DrugDevelopement In: Essentials of medical pharmacology. Jay pee brothers

medical publishers (p) ltd, New Delhi 6th ed.

Bentley, A. O., & Rawlins, E. A. (1977). Bentley's textbook of

pharmaceutics (8th ed.). London, United Kingdom: Bailliere Tindall.

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