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{{Short description|WHO formulary}}
{{for multi|the current list|WHO Model List of Essential Medicines|the current list for children|WHO Model List of Essential Medicines for Children}}

[[File:V1 40 years Model List of Essential Medicines.001.png|thumb|upright=1.4|2017 marked the 40th anniversary of the WHO Model List of Essential Medicines]]
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'''Essential medicines''', as defined by the [[World Health Organization]] (WHO), are the medicines that "satisfy the priority [[health care]] needs of the population".<ref name=WHO2017Web/> These are the medications to which people should have access at all times in sufficient amounts. The prices should be at generally affordable levels.<ref name=WHO2003>{{cite web |publisher=[[World Health Organization]] (WHO) |work= Essential Medicines and Health Products Information Portal |url= http://apps.who.int/medicinedocs/en/d/Js4875e/5.2.html |archive-url= https://web.archive.org/web/20140201194528/http://apps.who.int/medicinedocs/en/d/Js4875e/5.2.html |url-status= dead |archive-date= February 1, 2014 |title= The Selection and Use of Essential Medicines (ss 4.2) |series= WHO Technical Report Series |number= 914 |date= 2003 |pages= 132 }}</ref> Since 1977, the WHO has published a model list of essential medicines, with the [[WHO Model List of Essential Medicines|current (2019) list for adult patients]] containing over 400 medicines.<ref name="WHO 2019 adult">{{cite document |title=World Health Organization model list of essential medicines: 21st list 2019 |date=2019|hdl=10665/325771 }}</ref> Since 2007, a [[WHO Model List of Essential Medicines for Children|separate list of medicines intended for child patients]] has been published.<ref name="WHO 2019 child">{{cite document |title=World Health Organization model list of essential medicines for children: 7th list 2019 |date=2019|hdl=10665/325772 }}</ref> Both the WHO adult and children's lists contain a notation indicating that a particular medication is "complementary", thus essentially there are two lists, the "core list" and the "complementary list". The ''core list'' presents a list of minimum medicine needs for a basic health care system, listing the most efficacious, safe and cost-effective medicines for priority conditions. Priority conditions are selected on the basis of current and estimated future public health relevance, and potential for safe and [[cost-effective]] treatment. The ''complementary list'' presents essential medicines for priority diseases, for which specialized diagnostic or monitoring facilities are needed. In case of doubt medicines may also be listed as complementary on the basis of higher costs or less attractive cost-effectiveness in a variety of settings. The list is important because it forms the basis of [[national drugs policy]] in more than 155 countries, both in the [[developed countries|developed]] and [[developing world]]. Many governments refer to WHO recommendations when making decisions on health spending. Countries are encouraged to prepare their own lists taking into consideration local priorities. Over 150 countries have published an official essential medicines list.<ref name=Sey2011>{{cite book|last1=Seyberth|first1=Hannsjörg W.|last2=Rane|first2=Anders|last3=Schwab|first3=Matthias|title=Pediatric Clinical Pharmacology|date=2011|publisher=Springer Science & Business Media|isbn=9783642201950|page=358|url=https://books.google.com/books?id=jM1gob3MeVYC&pg=PA358}}</ref>

==Theory and practice==
The definition of essential medicines has changed over time.

The original WHO definition in 1977 was that they were medicines "of utmost importance, basic, indispensable, and necessary for the healthcare needs of the population".<ref>{{cite document |title=Action programme on essential drugs: progress report by the Director-General |date=2019|hdl=10665/153132 }}</ref> The concept was mentioned in one of the ten points of the 1978 [[Alma Ata Declaration]] on [[primary health care]].

In 2002 definition was changed to:

{{blockquote|Essential medicines are those that satisfy the priority health care needs of the population.<ref>{{cite web |publisher= [[World Health Organization]] (WHO)
|title= Trade, foreign policy, diplomacy and health |work= Essential Medicines |date= Dec 6, 2010 |url=https://www.who.int/trade/glossary/story025/en/ |archive-url=https://web.archive.org/web/20040806144535/http://www.who.int/trade/glossary/story025/en/ |url-status=dead |archive-date=August 6, 2004 }} </ref>}}

And this remains the definition {{as of|2019|lc=yes}}.<ref name=WHO2017Web>{{cite web|title=Essential medicines|url=https://www.who.int/medicines/services/essmedicines_def/en/|archive-url=https://web.archive.org/web/20081002110638/http://www.who.int/medicines/services/essmedicines_def/en/|url-status=dead|archive-date=October 2, 2008|website=[[World Health Organization]] (WHO)|access-date=20 January 2017}}</ref>

===Selection===
Items are chosen as essential medicines based on how common the disease that is being treated, evidence of benefit, the degree of side effects and the cost compared to other options.<ref>{{cite journal|last1=Kalle|first1=H|title=Essential Medicines for Children|journal=Clinical Pharmacology and Therapeutics|volume=101|issue=6|pages=718–720|date=9 February 2017|pmid=28182281|doi=10.1002/cpt.661|s2cid=23873145}}</ref>

===Cost-to-benefit ratio===
[[Cost effectiveness]] is the subject of debate between producers (pharmaceutical companies) and purchasers of drugs (national health services). It is estimated that access to essential medicines could save 10 million people a year.<ref>{{cite book|last1=Zacher|first1=M.|last2=Keefe|first2=Tania J.|title=The Politics of Global Health Governance: United by Contagion|date=2008|publisher=Springer|isbn=9780230611955|page=107|url=https://books.google.com/books?id=FdnGAAAAQBAJ&pg=PA107}}</ref>

==History==
The [[WHO Model List of Essential Medicines]] has been updated every two years since 1977. The 21st version was published in April 2019.<ref name="WHO Executive summary">{{cite book | vauthors = ((World Health Organization)) | year = 2019 | title = Executive summary: the selection and use of essential medicines 2019: report of the 22nd WHO Expert Committee on the selection and use of essential medicines | publisher = World Health Organization | location = Geneva | author-link = World Health Organization | hdl = 10665/325773 | id = WHO/MVP/EMP/IAU/2019.05. License: CC BY-NC-SA 3.0 IGO | hdl-access=free }}</ref>

===Children's list===
The first edition of the "WHO Model List of Essential Medicines for Children", was published in 2007, while the 7th edition was published in 2019.<ref name=Sey2011/><ref name="WHO 2019 child" /><ref name="WHO Executive summary" /> It was created to make sure that the needs of children were systematically considered such as availability of proper [[pharmaceutical formulation|formulations]].<ref name=Sey2011/> The first edition contained 450 formulations of 200 different medications.<ref name=Sey2011/>

===Number of medications===
{{Update|section|date=June 2019}}
The number of medications has nearly doubled, from the original 208 in 1977, to more than 340.<ref>{{cite web|title=10 facts on essential medicines|url=https://www.who.int/features/factfiles/essential_medicines/en/|archive-url=https://web.archive.org/web/20081116001239/http://www.who.int/features/factfiles/essential_medicines/en/|url-status=dead|archive-date=November 16, 2008|access-date=15 August 2015|date=February 2010|publisher=[[World Health Organization]] (WHO)}}</ref> The range has increased over the years and now{{when|date=September 2019}} includes an [[antimigraine]] drug, [[antidote]]s, and [[antineoplastic]] drugs. The third list for children from 2011, contains 269 medications.<ref>{{cite journal|vauthors=Bansal D, Purohit VK|title=Accessibility and use of essential medicines in health care: Current progress and challenges in India|journal=Journal of Pharmacology & Pharmacotherapeutics|date=January 2013|volume=4|issue=1|pages=13–8|pmid=23662019|doi=10.4103/0976-500X.107642|pmc=3643337}}</ref>

==Society and culture==
Access to essential medicines are part of the [[Sustainable Development Goals]], specifically goal 3.8.<ref name=Lancet2017>{{cite journal|vauthors=Wirtz VJ, Hogerzeil HV, Gray AL, Bigdeli M, de Joncheere CP, Ewen MA, Gyansa-Lutterodt M, Jing S, Luiza VL, Mbindyo RM, Möller H, Moucheraud C, Pécoul B, Rägo L, Rashidian A, Ross-Degnan D, Stephens PN, Teerawattananon Y, 't Hoen EF, Wagner AK, Yadav P, Reich MR|display-authors=6|title=Essential medicines for universal health coverage.|journal=Lancet|date=28 January 2017|volume=389|issue=10067|pages=403–476|pmid=27832874|doi=10.1016/S0140-6736(16)31599-9|pmc=7159295}}</ref>

A number of organizations, which are global in scope, use the list to determine which medications they will supply.<ref name=Sey2011/>

==See also==
* [[Campaign for Access to Essential Medicines]]
* [[Universities Allied for Essential Medicines]]
* [[Department of Essential Drugs and Medicines]]
* [[List of World Health Organization Essential Medicines]]

== References ==
{{Reflist}}

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Essential medicines - Revision history