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. 2013 Jan;4(1):13-8.
doi: 10.4103/0976-500X.107642.

Accessibility and use of essential medicines in health care: Current progress and challenges in India

Dipika Bansal  1 , Vilok K Purohit
Affiliations

Accessibility and use of essential medicines in health care: Current progress and challenges in India

Dipika Bansal et al. J Pharmacol Pharmacother. 2013 Jan.

Abstract

Essential Medicine Concept, a major breakthrough in health care, started in 1977 when World Health Organization (WHO) published its first list. Appropriate use of essential medicines is one of the most cost-effective components of modern health care. The selection process has evolved from expert evaluation to evidence-based selection. The first Indian list was published in 1996 and the recent revision with 348 medicines was published in 2011 after 8 years. Health expenditure is less in India as compared to developed countries. India faces a major challenge in providing access to medicines for its 1.2 billion people by focusing on providing essential medicines. In the future, countries will face challenges in selecting high-cost medicines for oncology, orphan diseases and other conditions. There is a need to develop strategies to improve affordable access to essential medicines under the current health care reform.

Keywords: Accessibility; India; essential medicines; health expenditures.

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Conflict of interest statement

Conflict of Interest: None declared.

Figures

Figure 1
Figure 1
Trends in WHO [10] and Indian EML [1112] *Including core and complementary medicines †WHO incorporated EML for Children (EMLc) from 2007 and the latest 3rd (2011) revision consists of 269 medicines ‡No complementary medicines are listed in the current EML **WHO has introduced its first EML in 1977 but India has introduced its NEML in 1996 with two revisions in 2003 and 2011
Figure 2
Figure 2
ATC Classification[25] of drugs in WHO EML (2011) and India EML (2011) *Items that are not included in ATC classes (e.g., coal tar, calamine, cryoprecipitate, etc.) †Total number of medicines is more than that of present in EML because some drugs are categorized in more than one class
Figure 3
Figure 3
State-wise health expenditure in India (2004-2005) (Source: National health accounts of India 2004-2005)[49]
See this image and copyright information in PMC

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