Essential medicines as defined by the World Health Organization (WHO) are “those that satisfy the priority health care needs of the population. They are selected with due regard to public health relevance, evidence on efficacy and safety, and comparative cost-effectiveness. Essential medicines are intended to be available within the context of functioning health systems at all times in adequate amounts, in the appropriate dosage forms, with assured quality and adequate information, and at a price the individual and the community can afford. The implementation of the concept of essential medicines is intended to be flexible and adaptable to many different situations; exactly which medicines are regarded as essential remains a national responsibility”.
The WHO Model list of Essential Medicines revised every two years provides a template and serves as a guide for countries to prepare their own lists taking into consideration local priorities.
Based on the current version of the WHO Model List of Essential medicines 20th edition published in 2017, the Ministry of Public Health in Lebanon through the Quality Assurance of Pharmaceutical Products Program prepared the National List of Essential Medicines EML 2018, four years after the last edition in 2014. The EML 2018 contains around 350 medicinal products and was prepared over one year by a Committee of Experts.
The EML is aligned with the National Drug Formulary and National Health Programs such as EIP Mother & Child, TB Control, HIV/AIDS, Malaria, National Mental Health Program and Primary Healthcare. The formulation and strengths of medicines listed in the EML are those mentioned under these National Health Programs and National Drug Formulary.
The Lebanese EML 2018 contains a core list and 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 consistent higher costs or less attractive cost-effectiveness in a variety of settings.
The list is divided into 30 sections related to the main Therapeutic classes of medicines and arranged in three columns;
INN of the medicine,
Dosage form and strength of the medicine
Official Status of the medicine
Medicines and dosage forms are listed in alphabetical order within each section with no implication of preference for one form over another.
The following symbols are used in the list to indicate the status of the medicine:
R: Registered drug in the Ministry of Public Health
NR: Non Registered drug in the Ministry of Public Health
HIV: included in the HIV Program
M: included in the MALARIA Program
NMHP: included in the NATIONAL MENTAL HEALTH Program
TB: included in the TUBERCULOSIS Program
U: provided through UNICEF Program
Y: provided through YMCA Program
[a]: indicates that there is an age or weight restriction on use of the medicine.
An index listing the Medicines by alphabetical order is available at the end of the document facilitating retrieval of information and easy reference.
We hope that all health providers would embrace this document as important tool for management of medicines and rationalizing prescription in the country. The EML 2018 welcomes comments from healthcare professionals; such comments help us to ensure that the National Essential medicines list remains relevant to practice.
The list can be accessed from the official website of the Ministry of Public Health: www.moph.gov.lb