The Essential Drugs Concept is a global idea promoted by the World Health Organization (WHO). It ensures that every country identifies a list of medicines that are absolutely necessary to meet the priority health needs of the population. These medicines are effective, safe, affordable and available at all times in proper dosage forms.
Definition
According to WHO, essential medicines are “medicines that satisfy the priority healthcare needs of a population.” They are selected based on disease burden, evidence of effectiveness, safety, and cost-effectiveness.
Selection of Essential Drugs
Essential medicines are chosen using both scientific and practical criteria:
- Public health relevance: Common diseases and prevalent health problems
- Evidence-based selection: Proven efficacy and safety
- Cost-effectiveness: Affordable for community and health systems
- Healthcare infrastructure: Availability of trained staff and proper storage conditions
- Ease of administration: User-friendly dosage forms, patient acceptability
The selection process must be updated regularly to include new evidence, changes in disease patterns, antimicrobial resistance and newly available formulations.
Importance of Essential Drugs
- They must be available at all times in adequate quantities and affordable prices.
- They should meet about 80–90% of a community’s healthcare needs.
- They provide a standardised approach to treatment and help ensure equitable healthcare.
- Availability of essential drugs helps reduce deaths from common, treatable diseases like diarrhea, pneumonia and neonatal infections.
Essential Medicine List (EML)
The Essential Medicine List (EML) is a carefully selected list of medicines needed for a country or state. Its purpose is to improve treatment outcomes, simplify drug management and reduce healthcare costs.
Key Features:
- Limited and focused list of essential medicines
- Selected based on disease patterns, efficacy, safety and cost-effectiveness
- Regularly updated based on current scientific evidence
- Includes medicines used in Standard Treatment Guidelines (STGs)
Advantages of Having an EML
1. Better Healthcare Outcomes
If essential medicines are available at all levels of healthcare, treatable conditions are managed effectively, reducing preventable deaths.
2. Easier Procurement and Storage
- Smaller number of medicines simplifies procurement
- Reduces stock-outs and wastage
- Improves quality control and transport logistics
3. Improved Use by Healthcare Providers
Doctors and pharmacists can develop a deep understanding of a limited number of medicines, improving prescribing and dispensing accuracy.
4. Better Compliance with Treatment Guidelines
Since EML medicines are included in STGs and national programs, following the list ensures proper treatment practices.
Rational Use of Drugs
Rational drug use means giving the right drug, at the right dose, for the right duration, to the right patient, at the right cost.
Factors contributing to irrational drug use:
- Self-medication
- Easy access to prescription drugs without supervision
- Using medicines based on advice from friends or family
- Desire to avoid consulting a doctor
Types of Irrational Use:
- Polypharmacy: Using too many drugs unnecessarily
- Incorrect antibiotic use: Wrong dose, short duration, or using antibiotics for viral infections
- Overuse of injections when oral medicines suffice
- Inappropriate self-medication
- Failure to follow STGs
Strategies to Improve Rational Drug Use
Many measures can help ensure drugs are used correctly in the healthcare system.
1. Managerial Strategies
- Encourage doctors to follow STGs
- Promote use of EML in prescribing
- Use prescription audits to monitor performance
2. Economic Strategies
- Provide incentives for using essential medicines
- Insurance reimbursement based on essential drug lists
- Competitive pricing by manufacturers
3. Regulatory Strategies
- Restrict prescribing rights to qualified professionals
- Implement drug scheduling and ban unsafe drugs
- Regulate pharmaceutical promotional practices
4. Educational Strategies
- Continuous training for healthcare professionals
- Promote use of unbiased drug information sources
- Educate patients on the correct use of medicines
- Combine education with monitoring and feedback
National Strategies for Rational Use of Medicines
WHO recommends several national-level measures:
- Establish a national authority to oversee medicine policies
- Prepare evidence-based STGs
- Create and implement an EML
- Set up Drug and Therapeutics Committees (DTCs)
- Introduce problem-based pharmacotherapy in medical education
- Make continuing medical education mandatory
- Provide unbiased drug information sources
- Conduct prescription monitoring and audits
- Enforce drug regulations and ethical promotion
- Ensure adequate funding for essential medicines
Role of Pharmacists in Promoting Rational Drug Use
Pharmacists have a major responsibility in ensuring that medicines are used safely and effectively.
Key roles include:
1. Member of Drug and Therapeutics Committee (DTC)
Participate in selection of essential medicines and EML implementation.
2. Drug Procurement
Ensure medicines procured are of good quality, affordable and based on actual needs.
3. Drug Storage
Proper storage, prevention of stock-out, and safe handling of expired or controlled medicines.
4. Dispensing
Accurate dispensing of medicines for both inpatients and outpatients.
5. Patient Education
Counsel patients on correct medicine use and improve adherence.
6. Pharmacovigilance
Monitor and report adverse drug reactions.
7. Drug Information Service
Provide unbiased drug information to doctors, patients and healthcare workers.
8. Pharmaceutical Care
Work closely with healthcare teams to ensure all medicine-related needs of patients are met.
Detailed Notes:
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