Essential Medicines & Rational Drug Use

Essential Medicines & Rational Drug Use

1. The Essential Medicines concept — definition & rationale

• WHO definition: Essential medicines are "those that satisfy the priority healthcare needs of the population." They are selected with due regard to public-health relevance, evidence on efficacy and safety, and comparative cost-effectiveness (KDT 8e Ch-01, p.6).
• Essential medicines are intended to be available within the context of functioning health systems at all times, in adequate amounts, in appropriate dosage forms, with assured quality and adequate information, and at a price the individual and the community can afford (the "5 A's" framing — availability, affordability, appropriate dosage form, assured quality, adequate information) (KDT 8e Ch-01, p.6).
• Padmaja's restatement: medicines required to meet the primary-healthcare needs of the majority of the population, available at all times in adequate amounts and appropriate dosage forms (Padmaja 7e Ch-05, p.73).
• Underlying rationale (KDT 8e Ch-01, p.6):
  • Only a handful of medicines out of the multitude available can meet the healthcare needs of the majority in any country.
  • Many well-tested, cheaper medicines are equally (or more) efficacious and safe as their newer, more expensive congeners.
  • For optimum utilisation of resources, governments — especially in developing countries — should concentrate on identifying these as essential medicines.
• Documented benefits of adopting an EML for procurement/supply (especially in the public-sector system) (KDT 8e Ch-01, p.6; Padmaja 7e Ch-05, p.73):
  • Improved availability of medicines.
  • Cost saving.
  • More rational use of drugs.
  • Greater coordination in healthcare development; basis for national formularies; a short list aids community health workers in primary care; emphasises the need for drug R&D (a new drug's safety/efficacy must be established before EML inclusion).
• ⚠ Terminology note: the modern WHO term is "essential medicines" (the 2002 rename from "essential drugs"); KDT still uses both interchangeably. Use "essential medicines / WHO EML / NLEM" rather than the bare phrase "essential medicine".