The World Health Organization's Essential Medicines List: An Endorsement of Incremental Innovation and Follow-On Research

ABSTRACTSixteen years ago, Lasagna et al. conducted a study designed to determine the impact of “me-too” drugs and follow-on research on the quality and quantity of drug therapies. Using the World Health Organization's (WHO) Essential Medicines List (EML) as a template for the most important medicines used around the world, they found that in 1987, about 50% of the drugs advocated by WHO were not innovator drugs but the result of follow-on research. Irrespective of these results, critics have continued to decry molecularly modified drugs and follow-on research as a mere profit tool of the pharmaceutical industry. As the debate is yet unresolved, the Center for Pharmaceutical Health Services Research (CPHSR) at Temple University felt it was time to reevaluate the current EML to find out whether or not molecular modifications have continued to improve drug therapy. Using the same methodology as the Lasagna study, an analysis of the 2003 EML showed that 81% of the drugs on the list were “me-too” products. Fu...