E-DRUG: Assessing variation among the national essential medicines lists of
21 high-income countries
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BMJ published this article:
Taglione MS, Persaud N
Assessing variation among the national essential medicines lists of 21
high-income countries
BMJ Open 2021;11:e045262. doi: 10.1136/bmjopen-2020-045262
https://bmjopen.bmj.com/content/11/8/e045262.info
Abstract:
Objective
Essential medicines lists have been created and used globally in countries
that range from low-income to high-income status. The aim of this paper is
to compare the essential medicines list of high-income countries with each
other, the WHO's Model List of Essential Medicines and the lists of
countries of other income statuses.
Design
High-income countries were defined by World Bank classification.
High-income essential medicines lists were assessed for medicine inclusion
and were compared with the subset of high-income countries, the WHO?s Model
List and 137 national essential medicines lists. Medicine lists were
obtained from the Global Essential Medicines database. Countries were
subdivided by income status, and the groups' most common medicines were
compared. Select medicines and medicine classes were assessed for inclusion
among high-income country lists.
Results
The 21 high-income countries identified were most like each other when
compared with other lists. They were more like upper middle-income
countries and least like low-income countries. There was significant
variability in the number of medicines on each list. Less than half (48%)
of high-income countries included a newer diabetes medicines in their list.
Most countries (71%) included naloxone while every country including at
least one opioid medicine. More than half of the lists (52%) included a
medicine that has been globally withdrawn or banned.
Conclusion
Essential medicines lists of high-income countries are similar to each
other, but significant variations in essential medicine list composition
and specifically the number of medications included were noted. Effective
medicines were left off several countries' lists, and globally recalled
medicines were included on over half the lists. Comparing the essential
medicines lists of countries within the same income status category can
provide a useful subset of lists for policymakers and essential medicine
list creators to use when creating or maintaining their lists.
Correspondence to
Dr Michael Sergio Taglione
Department of Family and Community Medicine, University of Toronto Faculty
of Medicine, Toronto, Ontario, Canada
mike.s.taglione@gmail.com