National List of Essential Medicines (NLEM)

Union Minister for Health and Family Welfare launched the National Lists of Essential Medicines (NLEM) 2022.

384 drugs have been included in this list with the addition of 34 drugs, while 26 from the previous list have been dropped.
Several antibiotics, vaccines and anti-cancer drugs are set to become more aﬀordable with their addition to the list.
“However, in respect of cancer, it is disappointing that more of the highly-priced, effective treatments for various cancers have not been included in the list.
It is positive that the diabetes section has been expanded to include teneligliptin and insulin glargine.
The inclusion of a drug in the NLEM mandates that it is sold at prices fixed by the NPPA.

As per the World Health Organisation (WHO), Essential Medicines are those that satisfy the priority health care needs of the population.

The National list of essential medicines is one of the key instruments in a balanced healthcare delivery system of a country which inter alia includes accessible, affordable quality medicine at all the primary, secondary, and tertiary levels of healthcare.
The first National List of Essential Medicines of India was prepared and released in 1996.
The drugs in the NLEM are included in the schedule category and their price is regulated by the National Pharmaceutical Pricing Authority (NPPA).
Issued by: Ministry of Health and Family Welfare.
It is based on the World Health Organisation’s (WHO) Model List of Essential Drugs.
Purpose of the National List of Essential Medicines
- Guide safe and effective treatment of priority disease conditions of a population.
- Promote the rational use of medicines.
- Optimise the available health resources of a country It can also be a guiding document for:
- State governments prepare their list of essential medicines.
- Procurement and supply of medicines in the public sector.
- Reimbursement of cost of medicines by organisations to its employees.
- Reimbursement by insurance companies.
- Identifying the ‘MUST KNOW’ domain for the teaching and training of health care professionals.

Medicine should be useful in diseases which are a public health problem in India.
Medicine should be licensed/ approved by the Drugs Controller General (India) (DCGI).
Medicine should have proven efficacy and safety profiles based on scientific evidence.
Medicine should be comparatively cost-effective.
Medicine should be aligned with the current treatment guidelines
Recommended under National Health Programs of India. (e.g. Ivermectin part of Accelerated Plan for Elimination of Lymphatic Filariasis 2018).
when more than one medicine is available from the same therapeutic class, one prototype/ medically best-suited medicine of that class is to be included.
The price of total treatment is considered and not the unit price of a medicine.
Fixed dose combinations are usually not included.
Vaccines as and when are included in the Universal Immunisation Program (e.g. Rotavirus vaccine).

The medicine has been banned in India.
There are reports of concerns about the safety profile of a medicine.
A medicine with better efficacy or favourable safety profiles and better cost-effectiveness is now available.
The disease burden for which a medicine is indicated is no longer a national health concern in India.
In the case of antimicrobials, if the resistance pattern has rendered a medicine ineffective in the Indian context.

Pic Courtesy: freepik

Content Source: The Hindu