National List of Essential Medicines of India

NLEM, or the National List of Essential Medicines, is a crucial tool in prioritizing healthcare needs and guiding decision-making in the pharmaceutical sector. It includes a list of vital drugs deemed necessary for the population's healthcare, focusing on efficacy, safety, and cost-effectiveness.
The National List of Essential Medicines (NLEM) outlines the essential medications that are vital for addressing the priority health needs of the population. It plays a crucial role in ensuring the availability and accessibility of essential medicines in primary health care services.

1. Introduction to NLEM NLEM, or the National List of Essential Medicines, is a crucial tool in prioritizing healthcare needs and guiding decision-making in the pharmaceutical sector. It includes a list of vital drugs deemed necessary for the population's healthcare, focusing on efficacy, safety, and cost-effectiveness . The National List of Essential Medicines (NLEM) outlines the essential medications that are vital for addressing the priority health needs of the population. It plays a crucial role in ensuring the availability and accessibility of essential medicines in primary health care services. Dr Asif Khan Professor Kanachur Institute of Medical Sciences Mangalore

2. Rationale behind the NLEM Equitable Access: Ensures availability of essential medicines to all, regardless of income or location Cost-effective Treatment: Focuses on cost-effective medications to optimize healthcare resources Public Health Priority: Addresses prevalent health issues and prioritizes essential medications

3. Essential Medicines are intended to be available at all times In adequate amounts In appropriate dosage forms Of assured quality & adequate information at a price the individual & community can afford.

4. Categories of drugs included in the NLEM 1 Medicines used in Anaesthesia 2 Analgesics, Antipyretics, Non-steroidal Anti-inflammatory Drugs (NSAIDs), Medicines used to treat Gout and Disease Modifying Agents used in Rheumatoid Disorders 3 Antiallergics and Medicines used in Anaphylaxis 4 Antidotes and Other Substances used in Management of Poisonings/ Envenomation 5 Medicines used in Neurological Disorders 6 Anti-infective Medicines 7 Anti-cancer agents including Immunosuppressives and Medicines used in Palliative Care 8 Medicines affecting Blood 9 Blood products and Plasma substitutes 10 Cardiovascular Medicines 11 Dermatological Medicines (Topical) 12 Diagnostic agents 13 Dialysis components (Haemodialysis and Peritoneal Dialysis) 14 Antiseptics and Disinfectants 15 Diuretics 16 Ear, Nose and Throat Medicines 17 Gastrointestinal Medicines 18 Hormones, other Endocrine Medicines and Contraceptives 19 Immunologicals 20 Medicines for Neonatal Care 21 Ophthalmological Medicines 22 Oxytocics and Antioxytocics 23 Medicines used in treatment of Psychiatric Disorders 24 Medicines acting on the Respiratory tract 25 Solutions correcting Water, Electrolyte disturbances and Acid-base disturbances 26 Vitamins and Minerals 27 Medicines for COVID 19 management

5. Essential Medicines for Maternal and Child Health Essential medicines for maternal and child health encompass a wide range of pharmaceuticals, including those vital for prenatal care, management of labor, postpartum care, neonatal health, and pediatric illnesses. These medicines play a crucial role in ensuring the well-being and health of mothers and children across various healthcare settings.

6. Essential Medicines for Reproductive Health Emergency Contraceptives: Medications to prevent pregnancy after unprotected intercourse or contraceptive failure. Medications for Menstrual Disorders: Drugs to address irregular or excessive bleeding, and menstrual pain. Infertility Treatment Drugs: Essential medications to treat reproductive health disorders causing infertility.

7. Essential Medicines for Immunization Vaccines Vaccines are crucial for preventing infectious diseases through immunization. Pediatric Doses Special formulations and doses of essential vaccines for children's immunization. Vaccine Storage Proper storage and handling of vaccines to maintain their efficacy. Injection Safety Ensuring safe and sterile administration of vaccines to prevent infections.

8. Criteria for Selection in NLEM Evidence-Based The selection is based on scientific evidence of efficacy and safety. Disease Burden Medicines for diseases causing significant morbidity and mortality are prioritized. Cost-Effectiveness Consideration of the cost and cost-effectiveness of the medicines. Public Health Impact Emphasis on medicines that address public health needs and provide significant health benefits. Dr Asif Khan

9. NLEM 2022 updates Additions: New medications added to address emerging healthcare needs. Removals: Deprecated or less effective drugs removed from the list. Revisions: Updates to existing entries based on latest research and efficacy data. Dr Asif Khan

10. Comparison: WHO EML vs. NLEM WHO EML The World Health Organization's Essential Medicines List aims to identify the most essential medicines for a functioning healthcare system worldwide . -> Insulin & Metformin – classified as anti diabetics NLEM The National List of Essential Medicines is tailored to the specific healthcare needs and priorities of a particular country or region . -> Insulin & Metformin – classified as Hormones Dr Asif Khan

11. Need for NLEM The National List of Essential Medicines (NLEM) is essential to ensure the availability and accessibility of vital medications for a population's health needs. It addresses the necessity for affordable and quality medicines, especially for vulnerable and marginalized communities. Dr Asif Khan

12. Benefits of NLEM inclusion Access to Essential Medicines NLEM inclusion ensures access to critical and life-saving medications for the population. Regulated Pricing It helps control the prices of essential medicines, making them more affordable and accessible. Quality Assurance NLEM listing ensures that the medicines meet the required standards of quality and effectiveness. Healthcare Equity It promotes equity by ensuring that everyone has access to necessary medications, regardless of their financial status. Dr Asif Khan

13. Limitations of NLEM The limitations of the NLEM include the potential for outdated listings, difficulty in keeping up with emerging drugs, and challenges in standardizing the list across diverse healthcare settings. Additionally, there may be issues with accessibility and affordability of essential medicines included in the list. Dr Asif Khan

14. Impact of NLEM on healthcare 1 Access to Essential Medicines NLEM ensures availability of crucial medications, improving healthcare access. 2 Cost Reduction By regulating prices of essential medicines, NLEM minimizes financial burden on patients. 3 Quality Standards NLEM inclusion promotes adherence to quality standards, enhancing patient safety. Dr Asif Khan

15. Challenges in implementing NLEM 1 Resistance to Change Medical practitioners may resist changes to familiar medications. 2 Supply Chain Disruption Disruptions in the supply chain may affect medication availability. 3 Pricing and Affordability Ensuring affordable prices for essential medicines can be challenging. Implementing the NLEM may face challenges such as resistance to change from medical practitioners, disruptions in the supply chain affecting medication availability, and ensuring affordable pricing for essential medicines. Dr Asif Khan

16. The Future of Essential Medicines List (EML) Innovation New advancements in pharmaceuticals and healthcare Global Access Ensuring equitable access to essential medicines worldwide Research & Development Ongoing efforts in developing new essential medicines Healthcare Integration Integration of essential medicines into healthcare systems Dr Asif Khan

17. Dr Asif Khan