Which Drugs Should Be on the Essential Medicines List?

Courtney Perlino, Hilary Daniel, Amy B Cadwallader
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Abstract

The World Health Organization (WHO) published its first Essential Medicines List (EML) in 1977, and it is updated biennially. One might reasonably think drugs on the EML are there because they are critical to effective, evidence-based patient care and intervention. One might not reasonably guess, however, that a particular drug's supply chain vulnerabilities that make it a shortage risk would contribute to a drug's listing on the EML. This commentary on a case first describes why the WHO makes the EML and suggests reasons why it might be important to consider a drug's shortage risk when revising and updating it. This commentary also suggests how distinguishing "essential" drugs from "vulnerable" drugs could bolster supply chain resiliency and mitigate drug shortages' disruptions to patient care.
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哪些药物应列入《基本药物清单》?
世界卫生组织(WHO)于 1977 年发布了第一份《基本药物目录》(EML),该目录每两年更新一次。人们可能有理由认为,EML 上的药品之所以被列入,是因为它们对有效的循证病人护理和干预至关重要。然而,人们可能不会合理地猜测,某种药物的供应链漏洞会使其面临短缺风险,从而导致该药物被列入 EML。本案例评论首先描述了世卫组织制定 EML 的原因,并提出了在修订和更新 EML 时考虑药品短缺风险可能很重要的原因。本评论还提出了区分 "基本 "药物和 "易缺 "药物可如何增强供应链的弹性并减轻药物短缺对病人护理的干扰。
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