National List of Essential Medicines (NLEM)

National List of Essential Medicines (NLEM)

• The Union Health Ministry has released the updated National List of Essential Medicines (NLEM), which now includes 384 medications along with 34 new ones and 26 medications that were not on the previous list.
• The new anti-cancer therapies included are Bendamustine Hydrochloride, which is used to treat a certain type of blood and lymph node cancers; Irinotecan HCI Trihydrate used alone or in combination with other drugs to treat colorectal and pancreatic cancers; Lenalidomide for treating various type of cancers; and Leuprolide acetate, used to treat prostate cancer.
• According to the World Health Organization (WHO), essential medications are those that address the population's top health care needs.

What is The National List of Essential Medicines (NLEM)?

• The Ministry of Health and Family Welfare published a list called the National List of Essential Medicines (NLEM).
• The National Pharmaceutical Pricing Authority has set a price ceiling that the medications included in the NLEM are sold below (NPPA).
• It was designed in India in accordance with the WHO's Essential Medicines List (EML).

History:

• In 1996, the Ministry of Health and Family Welfare created and published India's first National List of Essential Medicines, which included 279 drugs. Later, this list was updated in 2003, 2011, 2015, and 2022.
• The goal is to direct safe and efficient treatment of a population's top illness issues.
• Encourage the sensible use of medications.
• Maximize a nation's available health resources.
• In order for state governments to compile their list of necessary medications, it can also serve as a guide.
• Public sector drug supply and drug procurement.

What Prerequisites Must a Medicine Meet in Order to Be Included in NLEM?

Before a medicine is included in the NLEM, a number of factors are considered. Which are:

• Essentiality: A drug should meet the criteria listed previously and may be necessary when taking the population as a whole into account.
• Variations in disease burden the burden of disease in the nation is continuously shifting over time. TB may have once been more urgently addressed. The importance of another illness, like Covid-19, could change in the near future. Therefore, when creating the list, the most common disease is taken into account.
• Efficacy and Safety: The medicine must have "unequivocal" evidence of efficacy and wider acceptance based on its safety to be included in the list.
• Cost-Effectiveness: The total price of the treatment must be considered while including the drug in NLEM. Only unit price may not be the best benchmark for this.
• Fixed Dose Combinations (FDCs): The single-dose medicines are considered for inclusion in NLEM. FDCs are only included if they have a proven advantage concerning the therapeutic effect.
• Turnover: High sales turnover alone is not considered a good benchmark for inclusion in the NLEM. Other factors are also required to be essentially considered for it..

When is a Drug Removed from the NLEM?

• If a drug is outlawed in India, it is removed from the list. Additionally, it is taken out if there are any reports of drug safety issues.
• If a medication has improved efficacy, a favorable safety profile, or higher cost-effectiveness, it is taken out of the NLEM.

Essential Medicine List (EML)

• Disease prevalence, medication effectiveness, safety, and comparative cost-effectiveness are taken into account when compiling the list.
• Such medications ought to be accessible in a way that a person or a group of people can afford them.
• The Expert Committee on Selection and Use of Essential Medicines updates the WHO EML every two years.
• Tanzania was the first nation to create its EML in the world in 1970. The World Health Assembly (WHA) then asked WHO to help member nations choose and purchase vital medications in 1975, guaranteeing good quality at a fair price.
• The first WHO model list of essential medications, which included 186 medications, was subsequently released in 1977.