Comparison of essential medicines lists in 137 countries

Bulletin of the World Health Organization
Volume 97, Number 6, June 2019, 377-440
https://www.who.int/bulletin/volumes/97/6/en/

 

Research
Comparison of essential medicines lists in 137 countries
— Nav Persaud, Maggie Jiang, Roha Shaikh, Anjli Bali, Efosa Oronsaye, Hannah Woods, Gregory Drozdzal, Yathavan Rajakulasingam, Darshanand Maraj, Sapna Wadhawan, Norman Umali, Ri Wang, Marcy McCall, Jeffrey K Aronson, Annette Plüddemann, Lorenzo Moja, Nicola Magrini & Carl Heneghan
http://dx.doi.org/10.2471/BLT.18.222448
Abstract
Objective
To compare the medicines included in national essential medicines lists with the World Health Organization’s (WHO’s) Model list of essential medicines, and assess the extent to which countries’ characteristics, such as WHO region, size and health care expenditure, account for the differences.
Methods
We searched the WHO’s Essential Medicines and Health Products Information Portal for national essential medicines lists. We compared each national list of essential medicines with both the 2017 WHO model list and other national lists. We used linear regression to determine whether differences were dependent on WHO Region, population size, life expectancy, infant mortality, gross domestic product and health-care expenditure.
Findings
We identified 137 national lists of essential medicines that collectively included 2068 unique medicines. Each national list contained between 44 and 983 medicines (median 310: interquartile range, IQR: 269 to 422). The number of differences between each country’s essential medicines list and WHO’s model list ranged from 93 to 815 (median: 296; IQR: 265 to 381). Linear regression showed that only WHO region and health-care expenditure were significantly associated with the number of differences
Conclusion
The substantial differences between national lists of essential medicines are only partly explained by differences in country characteristics and thus may not be related to different priority needs. This information helps to identify opportunities to improve essential medicines lists.